educationally related mental health procedures · nurturing environments for children promotes...

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San Mateo County SELPA

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Educationally Related Mental Health Procedures

San Mateo County SELPA (October 2017)

Ma teo Ocnmty

EPA

Special Education Local Plan Area (SELPA) 101 Twin Dolphin Drive bull Redwood City CA 94065-1064 bull (650) 802-5464 bull Fax (650) 802-5474

Educationally Related Mental Health Services Procedures

History Both education and mental health systems have a long history of providing mental health services to studentsSometimes these services are delivered collaboratively between the two systems but more often the services work in parallel fashion with each other or do not operate effectively at all in either system (Kutash Duchnowskiamp Lynn 2006) California utilized the legislative process to define the relationship between the public school system and county mental health In 1984 Assembly Bill 3632 statutorily required a partnership between school districts and county mental health agencies to deliver mental health services to students with individualizededucation programs (IEPs) In 2011 the California Legislature passed Assembly Bill 114 which repealed the state mandate on special education and county mental health agencies and eliminated related references to mental health services in California statute As a result of this new legislation school districts are solely responsible for ensuring that students with disabilities receive special education and related services to meet their needsaccording to the Individuals with Disabilities Education Act (IDEA) of 2004

Mental health as a related service is identified as mental health services necessary for a student to benefit fromtheir special education program Within the educational environment these can include assessment of needs for mental health services crisis intervention within the educational setting outpatient counseling day treatmentplacement case management parent consultation andor residential placement recommendations Please note that medication management is not included among these services since federal guidelines consider it a medically necessary and not an educationally necessary service The term ldquomental health as a related servicerdquo is currentlyutilized in place of ldquoAB3632rdquo or ldquo265 servicesrdquo Mental health a related service and Educationally Related Mental Health Services (ERMHS) can be used interchangeably

Such significant reform requires intensive action sustained over several years It involves not only putting intoplace the latest policy but also changing the cultures of classrooms schools and districts (Fullan 1991) Parents schools and communities all have a role to play in making sure children develop in a healthy way Creating nurturing environments for children promotes healthy development The Preventing Mental Emotional andBehavioral Disorders among Young People brochure (National Academies Press 2009) indicates

Healthy children feel good about themselves and their abilities They make friends get along with their peers and can cope with lifersquos stresses Healthy children learn and behave appropriately at school

Healthy families are nurturing and positive provide stimulating activities engage in positive communication and provide support for their children especially during times of stress

Healthy schools expect children to do well academically have teachers who manage their classrooms well and offer opportunities for partnerships with parents

SELPA Mental Health Handbook (updated 10317) 0 of 52

Healthy communities offer high-quality child care and learning opportunities for young children They provide support services to children and their families and opportunities for children to build skills andexplore in work and school

Mental health issues also range along a continuum Mental health and mental illness are not mutually exclusive categories but are points on a continuum ranging from positive mental health through mental health problems to mental illnesses (Surgeon General 2007)

Mental Health ndash a state of successful performance of mental function resulting in productive activitiesfulfilling relationships with other people and the ability to adapt to change and cope with adversity

Mental Health Problems ndash signs and symptoms of insufficient intensity or duration to meet the criteria forany mental disorder Mental health problems may warrant active efforts in health promotion prevention and treatment

Mental Illnesses ndash all diagnosable mental disorders health conditions characterized by alterations in thinking mood or behavior (or some combination thereof) associated with distress andor impaired functioning

Unfortunately about 20 of children in the United States experience mental emotional andor behavioral problems (National Academies Press 2009) This means that almost one in five young people have a diagnosable mental emotional or behavioral disorder Many of these disorders have lifelong effects that include high psychosocial and economic costs not only for the child but also for their families schools and communitiesChildren and adolescents with social- emotional-behavioral difficulties may exhibit chronic and diverse academic emotional behavioral andor medical difficulties that pose significant challenges for their performance in schoolsWhile the number of children who experience mental emotional andor behavioral problems is relatively high not all of them qualify as having a mental disorder or emotional disturbance ndash so they may or may not besupported by a mental health agency or special education Given this it is important to look at how education can assume not only the responsibilities delegated under AB 114 but also meet the needs of all students in need of mental health supports This document is written to assist local educational agencies (LEAs) in the developmentand implementation of mental health services in schools It is designed as a resource for school personnel to work through the change process which includes the stages of initiation design and development implementationevaluation and continuation Initiation includes responding to changes by identifying leaders for the team and mobilizing people to move forward to adoption of a plan Design and development leads the members to making decisions and experiencing beginning steps of putting their plan into action Implementation provides the means toachieve both the desired process and outcomes Evaluation provides continuous interaction across the stages and can serve as feedback to possibly alter decisions and plans Continuation occurs when new practices becomeroutine and are incorporated as the norm within an institution Organizational change is a process not a linear event and the total time frame from initiation to institutionalization can take multiple years (Fullan 1991)

Purpose With everything else educators are responsible for some may ask why we now have to take on mental health supports Focusing on healthy development helps children master the skills necessary to succeed in life andprovides opportunities to step in before problems occur From birth to age five children change more than during any other stage of their lives and helps develop a firm foundation for the rest of their lives Important developmental foundations of social-emotional competence begin at birth (Yates Ostrosky Cheatham Fettig Shaffer amp Santos 2008) Early experiences influence how infants toddlers and young children begin to understand control and master their world and how they form perceptions of self For 4 example infants initiallyexpress their wants and needs by crying smiling and turning toward or away from what they like or dislike When


these needs are consistently and lovingly met infants are more easily comforted pay more attention to what is going on around them are more open to exploring their environments are better able to calm themselves andregulate their emotions learn that they can affect others through their actions and begin to develop secure attachments to their caregivers In addition to feeling safe comfortable and close to their parents children mustlearn to focus their attention and express and manage their feelings so they can get along with others They also begin to make friends and relate to peers The emergence of these social emotional skills helps children feel more confident and competent in developing relationships building friendships resolving conflicts persisting whenfaced with challenges coping with anger and frustration and managing emotions During middle childhood children begin to attend school and develop academically They learn to follow rules develop positive relationshipswith friends and school mates and learn to adapt to lifersquos stresses A young child who is able to relate to others is motivated to learn and can calm him or herself or be calmed by others will be ready to learn and experience success in school and in life During adolescence teenagers must develop the skills necessary to carry them into adulthood ndash establish good health habits critical thinking and problem solving skills and a sense of being individuals who are well connected to friends family and the community While Californiarsquos recent legislationtransition of responsibility for provision of mental health services to schools was primarily motivated by funding issues it is supported by Frankfordrsquos (2007) assertion that schools are strategically placed to implementcomprehensive prevention and intervention programs for children School personnel see the full continuum of young peoplersquos mental health needs from children at risk to those with serious emotional andor behavioral disorders Per Frankford

A major set of protective factors for high-risk youth has to do with school including development of the childrsquos cognitive skills interactions with peers and adults with prosocial values and connectedness toschool

More than three fourths of children who receive any mental health services are seen in the educationsystem for many this is the sole source of care

The longer adolescents stay in school and the more successful they are in school the more likely it is that they will not be involved in substance abuse and will not experience mental health problems The lesssuccessful students are in school the more at risk they are for conduct disorders substance abuse and engagement in risky behaviors with regard to their health

For children mental health is not seen as residing solely within the child but within the web of interactions among the individual child the family the school health other child service systems the neighborhoods and communities in which the child lives (SAMHSA 2007) In particular neighborhood characteristics and familyincome can be risk factors that impact young childrenrsquos social-emotional health and development

Young children in low-income neighborhoods are more likely to experience behavioral problems thanchildren living in moderate or affluent neighborhoods

Young children from households with lower levels of family income are more likely to experience behavioral problems that negatively impact their development

Family risk factors particularly maternal risk factors such as substance use mental health conditions and domestic violence exposure can impact parentsrsquo ability to support childrenrsquos development and may contribute to behavioral problems among young 5 children as early as age

Young children with these family risks factors have been found to be two to three times more likely thanchildren without these family risk factors to experience problems with aggression (19 vs 7) anxiety and depression (27 vs 9) and hyperactivity (19 vs 7) (National Center for Children in Poverty wwwnccporg)

Attention to mental health issues that arise within the school environment are important for other reasons as well Children at risk of developing mental emotional andor behavioral health problems can be identified early (The National Academies 2009) Doing so can prevent some problems before they ever happen and treat others when


symptoms first appear Research also suggests that greater and more long-term benefits accrue when programs begin early in the lives of children Mental health problems often are precursors to delinquency substance abuse health-risking sexual behaviors and school failure (see SAMHSA 2007) Conclusions drawn from some of the cited studies are that

Children in first grade with the combination of hyperactivity and social problem-solving deficits have been found to have a greatly increased rate of drug and alcohol use when they are between 11 and 12 years old

Children in first grade with conduct problems anxiety or depression or attention deficitndash hyperactivity disorder have approximately twice the risk of first tobacco use during fourth through seventh grade than do children without these early emotional disorders

Social impairment in childhood is a critical predictor for later substance abuse disorders Conduct problems predict the initiation of alcohol use as well as greater escalations of alcohol use over time

Children who lack prosocial behavior skills are likely to be rejected by their peers and to gravitate toward other rejected children These socially isolated peer groups in turn promote substance abuse and involvement in antisocial activities

Identifying the Who A tiered approach to interventions is a means to provide mental health services in schools that focus on promoting positive mental healthsocial and emotional development addressing mental health problems as they present barriers to learning providing linkages to community agencies and resources and mental health resources delivered within or linked to school settings By using a variety of funding sources to connect programs and services schools and communities can provide students with a seamless system of prevention early intervention and intensive services Setting up tiers of support services based upon an intensity of need model provides the means for schools to provide appropriate levels of interventions before recommending a more restrictive settingIn a multi-tiered model it is conceivable that a variety of personnel will provide supports at the identified levels of intervention

If maximum effectiveness is to be achieved then developing working relationships is an essential ingredient No matter which job description applies to an individual there are a generalized set of skills abilities work activities and work styles needed for success in the public school environment Communication is vital in this field so personnel must be able to communicate effectively with children adolescents parents and other persons involved with the child She also needs interpersonal and self-awareness attributes and should have a strong sense of wanting to help and work with children The joy of working with students experience in working with children who have emotional disabilities and the ability to deal effectively with attitudes and behaviors of children is highlydesirable One must establish and maintain effective and cooperative working relations with parents students and teachers work 6 independently and as a team player maintain flexibility and utilize sound judgment and maintain strict confidentiality In addition often one must be able to concentrate on multiple tasks in an active busy environment utilize various technological machines and computers maintain regular steady attendance demonstrate integrity adaptability flexibility good judgment dependability and have the ability to workeffectively and efficiently under pressure

Leadership and coordination of efforts is critical Because people who work with students with emotional challenges and their families often come from varied training programs bringing all people involved together for staff development activities is an essential concept for success It is also important to ―foster genuine workingrelationships with parents based on mutual understanding shared vocabulary and respect (Work Group 1991 p 9) The successful implementation of Tier I school-wide supports requires buy in from administration classifiedpersonnel teachers and support personnel For example since behavior is the reason so many students get


referred for special education efforts that empower teachers to manage a diversity of behavior enhances the self-esteem of both students and teachers adds to the acceptance of cultural differences and opens doors forcollaboration between teachers and specialists (Work Group 1991)

Tier II targeted interventions typically involved many of these staff members plus expanded team members such as a school psychologist school nurse behavior specialist special education teachers licensed professional clinical counselor (LPCC) or intern Tier III intensive mental health supports are typically provided by specially trainedpersonnel such as marriage family therapist intern (MFTI) licensed MFT (LMFT) licensed clinical social worker (LCSW) clinical therapist mental health case manager andor even a psychiatrist Administrative support may be provided by a variety of personnel (ie program specialist coordinator director assistant principal principal assistant superintendent superintendent) and across multiple divisions (ie administrative services educationalservices business services maintenance and operations)

The California Department of Education (CDE) published an advisory on September 13 2011 regarding the requirements for securing the services of mental health professionals to provide related services to special education students LEAs have the option to directly employ mental health professionals andor contract forcommunity-based mental health professionals to provide related services Such professionals are broadly defined as any individuals licensed and self-employed employed by a private agency or employed by a public agency such as County Mental Health Individuals and entities that are employees contractors or vendors of these publicagencies are authorized to provide the specific services to which they have been assigned and that authorization qualifies them to contract directly with LEAs to provide those same services Individuals and entities that are notcurrent contractors or vendors of the public agencies must hold a Nonpublic School or Nonpublic Agency (NPSA) certification in order to be eligible to provide related services Community-based mental health professionals mustbe supervised in their school-based activities by an individual possessing a Pupil Personnel Services (PPS) credential Per CDE the term ―supervised in this context means that the PPS credential holder has oversight of the school-based activities undertaken by a community-based mental health provider for the purpose of ensuring that these services are consistent with the needs of students served and are coordinated with other student services to allow for the provision of an efficient and comprehensive PPS program Issues of certification and supervision mustalso be considered

Getting to the HOW A tiered approach to interventions is a means to move students from universal to select targeted to intensive treatment interventions (and vice versa as appropriate)

ldquoDeliberate considered utilization of the full continuum of programs and service options enhances the appropriateness of interventions for any individual at any time It [a continuum of mental health interventions]

provides the opportunity for change to occur in either direction as the needs of the student change (Work Group 1991 p 3)rdquo

Students and parents generally feel safe in the school environment and are more comfortable with the familyorientation provided by service providers who work together in the same building The increase in family cooperation and enhanced exchange of information among providers has been shown to assist team efforts at intervention Embedding a values-based system of care model requires adapting and building upon the followingprinciples identified by

Multi-year programs are more likely to foster enduring benefits than short-term project


Preventive interventions are best directed at risk and protective factors rather than at categorical problem behavior It is both feasible and cost-effective to target multiple negative outcomes in the context of a coordinated set of programs

Interventions should be aimed at multiple domains changing institutions and environments as well as individuals

Prevention programs that focus independently on the adolescent are not as effective as those that simultaneously ―educate the adolescent and create positive changes in both the school and home environments

There is no single program component that can prevent multiple high-risk behaviors A package of coordinated collaborative strategies and programs is required in each community

Prevention programs need to be integrated with treatment systems to enhance linkages and sustainability Schools in collaboration with community providers are potential settings for the creation of such fully

integrated models (Greenberg Domitrovich amp Bumbarger 1999 cited in Frankford 2007)

Determination of Need for Mental Health Related Services While there is a continuum of mental health services available within a SELPA the focus for IEP teams is the determination of need for educationally related mental health services (ERMHS) as a related service based upon IDEA regulation and Education Code sect 56363 Students do not need to have a specific disability to receive ERMHS services School personnel look at concrete data (grades progress on goals behavior at school office referrals discipline patterns) to see if there are functional impairments getting in the way of the studentrsquos education (how the behaviors are impeding the educational process including but not limited to academic success) As such thequestion becomes more than would the student benefit from services rather does the student require ERMHS to access their academic environment

Focus on the educational impact of the studentrsquos disability is distinctly different from a medical model Having a mental health diagnosis and being on medications does not dictate educational need or indicate higher level of care However factors such as a studentlsquos responsiveness to physical healthcare treatment alone ability to access education in the least restrictive environment andor failure to demonstrate progress in educational performance may be considered as strong indicators of the studentrsquos amenability to the intervention currently being employed Clinical significance may also be seen in impeded ability to accomplish IEP goals including therapy planned goals

Remember ndash to determine educational necessity for mental health related services the studentrsquos identified disability must adversely impact educational performance If the team follows all policy and procedure to get tothis step it is recommended that the school psychologist or case manager initiate an Assessment PlanPrior Written Notice to gather more information about the studentlsquos social-emotional functioning in school In some cases the evaluation may need to be expedited (ie potential expulsion or other change in placement) In mostcases it is important to provide intervention during the time an evaluation is being conducted and incorporate the studentlsquos response to intervention data into the evaluation process and report Typically the LEA uses its standardassessment report format with a focus on the impact of the studentlsquos social emotional functioning on his or her school performance

Educationally Related Mental Health Services Educationally related mental health services are mental health services that are provided to students receivingspecial education services These services are provided when students have significant socio-emotional or socio-


behavioral needs that impede their ability to benefit from their special education services There must be a direct relationship between the emotionalbehavioral characteristics and the lack of educational benefit from special education services A referral is appropriate when these concerns are determined to be associated with a condition that can not be described solely as a temporary adjustment problem that can be resolved with less than three months of school based counseling Students eligible for mental health services are not just those identified as Emotionally Disturbed but can be those of any disability category The services will be regularly monitored for efficacy and due diligence Adjustments in the level of service will be made as appropriate An IEP will be held andthe service will be discontinued when the mental health goals are met signaling that the service(s) are no longer needed for the student to benefit from educationally related mental health services

Operating Principles Every individual with disabilities is entitled to a Free and Appropriate Education within the least restrictive environment A unique Individualized Education Plan is developed for each student from a continuum of services The ERMHS program strives to provide the appropriate mental health service at the level indicated by eachstudentrsquos need in order to achieve educational progress The service arraymenu is based upon a tiered-level approach and includes prevention brief intervention or intensive and individualized interventions Please note that the Tierrsquos below are meant for our Special Education Students Students in the school setting may be on Tier 3 but not eligible for Special Education

Tier I Prevention- These are universal prevention activities available through school districts San Mateo County Office of Education or within community agencies and organizations All students are eligible toaccess Tier I services and activities and do not need to be eligible for Special Education to participate Examples of these servicesprograms include counselors Positive Behavior Intervention Program SecondStep Bullying Prevention Program School Safety Plans (which may include responding to a mental health crisis on campus) Developmental Assets Student Study Teams First Five counseling and parenting education

Tier II Identification and Brief Intervention- This tier service targets those non Special Education students Special Education students or those in the process of special education assessment who have an emerging socio-emotional problem and who with brief support will be able to improve problem behaviors Examples of these services include identificationscreening by school psychologist as having socio-emotionalproblems and IEP has socio-emotional goals documented Behavior Intervention Plans School Psychologist services counseling services training for teacherscaregivers on behavior intervention socio-emotionalskill-building groups possible mental health evaluation completed and these related services are documented on IEP Short term Individual or Group therapy from mental health professionals and short term Parent Coachingconsultation If a crisis assessment raises lethality concerns the ERMHS Clinicianwill be responsible for making arrangements to send the student for a 5150 assessment In addition the ERMHS Clinician will provide a written progress report for IEP meetings ERMHS Tier III services will befocused primarily on helping the student meet their special education goals Data from measureable goals will be used when practical to determine whether the services provided have contributed to improvededucational success The ERMHS Clinician will be responsible for complying with all confidentiality regulations

Tier III Intensive Individualized Intervention is the most intensive service array and targets both the General Education and the Special Education student with significant problems due to mental healthdisorders and will be done within an interdisciplinary team model Less intensive services and short term


intervention has been attempted prior to referral for ERMHS Tier III services Examples of services at this level include mental health evaluation completed Intensivelonger term Individual or Group therapy frommental health professionals Parent Coaching possible WRAP services in the home a multidisciplinary team approach and communication with studentrsquos IEP Team and the possibility of a nonpublic schoolplacement or residential being the most restrictive option The mental health clinician which includes a credentialed education staff and licensed or license-waivered mental health therapists or contractors will be referred to as the ERMHS Clinician in the rest of this document At this level Behavior Health RecoveryServices (BHRS) are often times the provider of the mental health services At the Tier III Level education-related mental health services MAY include screening and assessment crisis intervention within the schoolsetting individual or group therapy communication with the case manager rehabilitation services treatment plan development collateral services for parent or caregivers and consultations regardingappropriate educational placements If a crisis assessment raises lethality concerns the ERMHS Clinician will be responsible for making arrangements to send the student for a 5150 assessment In addition the ERMHS Clinician will provide a written progress report for IEP meetings ERMHS Tier III services will befocused primarily on helping the student meet their special education goals Data from measureable goals will be used when practical to determine whether the services provided have contributed to improvededucational success The ERMHS Clinician will be responsible for complying with all confidentiality regulations

Pre-Referral Process Prior to referring a student to be assessed for ERMHS the School Team must hold an Individual Education Plan (IEP) meeting and consider Positive Behavior Support Services The team should consist of but not limited to the following members the case manager the studentrsquos parent(s) a general education teacher a site administrator the program coordinator(if applicable) school counselor if available and the school psychologist The pre-referral process includes review of current data collection of new data and implementation of available supports

Gather information from the studentrsquos parents and teacher(s) regarding social emotional behavioral and academic performance

Review the observation data or reports provided by the site staff Review available records of studentrsquos school attendance and discipline Review data indicating the history of parent-school contact Examine current supports available for the teacher and student at the school site Reviewing IEP goals that pertain to behavior change Collect data on positive school-wide behavior support system being used and intended to maximize the

studentrsquos positive behavior on a daily basis Collect data on positive classroom management systems and strategies being implemented to support the

studentrsquos positive behavior on a daily basis Collect data describing any previously attempted interventions and their relative effectiveness Review data on an implemented behavior intervention plan including a functional behavioral assessment(if

applicable) and a statement of the relative effectiveness of the plan

IEP Team Initiation of Referral for Mental Health Services The ldquoStudent Needs for Mental Health Support Rubricrdquo is recommended for use prior to initiating a mental healthreferral to determine if a mental health referral is appropriate In addition this rubric may be used as part of the


assessment process to determine continued need for mental health services Continue w referral process if rubric mostly notes ratings in 3rsquos amp 4rsquos in 2 or more areas

Eligibility Criteria ERMHS Tier II III students will have an active IEP or is in the process of a psycho-educational assessment for special education services and who is suspected of having significant socioemotional problems or have a mental illness diagnosis and is not making adequate educational progress due to the mental health problems Studentswho are eligible for ERMHS Tier III evaluation often require a great continuum of service which is provided mainly by BHRS or and NPSNPA IEP teams will determine which students with disabilities are eligible for mental healthrelated services The ERMHS Clinician or School Psychologist will be responsible for completion of a mental health initial eligibility evaluation and will provide a recommendation to the IEP team regarding eligibility andrecommended services The IEP Team and the ERMHS Clinician will develop specific goals and services which will be written into the IEP and routinely monitored for progress Eligible students are not solely identified under eligibility category Emotionally Disturbed but can be of any disability category Students can be anywhere on the continuum of placement and services as long as they meet the eligibility criteria

IEP Procedures

Initiating a referral for ERMHS Tier IIIII 1 Documenting need prior to referral The IEP must clearly document the suspectedidentified need related to mental health by compiling the following information

a The student has an active psycho-educational study (or is in process) and a copy is attached b Written consent to complete a mental health assessment and to share information between school staff and Clinical staff (if they are not a school district employee) is current and a copy is attached c Documentation lists the emotional or behavioral problems that

1 Have been observed by qualified educational staff in education settings and other settings as appropriate 2 Impede the student from benefiting from special education services3 Are significant as indicated by rate of occurrence and intensity 4 Are associated with a condition that cannot be explained solely as a social maladjustmentas demonstrated by deliberate noncompliance with accepted social rules a demonstrated ability to control unacceptable behavior and the absence of a mental disorder as defined bythe American Psychiatric Association 5 Are associated with a condition that cannot be described solely as a temporary adjustment problem that cannot be resolved with less than three months of schoolcounseling The student has exhibited socio-emotional problems for at least 6 months

2 Based upon an IEP team decision using educational assessments the studentrsquos current functioning including cognitive functioning is at a level sufficient to enable the student to benefit from mental health services (this does not include behavioral consultation services) 3 The IEP special education services as written on the IEP have been implemented4 The IEP team has implemented and reviewed behavior support plans for effectiveness 5 The IEP teams have determined the student is likely to benefit from ERMHS Tier III services6 Written consent for release or exchange of information for all relevant private service providers is copied and part of the referral packet


Students who are in the process of being evaluated for Special Education services or who transfer into San MateoCounty SELPA with a current IEP with Mental Health services listed may be referred to ERMHS Tier III concurrently This concurrent referral is only utilized in extraordinary circumstances for the student The SchoolPsychologist will validate the unique circumstance which necessitates expedited referral process pending the completion of the entire evaluation

Referral Packet for ERMHS TIER IIIII After the IEP team has initiated a referral the School Psychologist shall submit a packet with the following to the ERMHS TIER III Clinician

1 Referral checklist 2 Current IEP document and any subsequent addendums 3 Current Psycho-educational Assessment 4 Current assessment reports completed in all areas of suspected disabilities and any relevant outside agency reports recently completed 5 Letter from referring school counselorpsychologist verifying provision of counseling and guidanceservices and progress toward emotional or behavioral problems 6 Behavior Plan with statement regarding the effectiveness of this intervention 7 Parental consent for mental health assessment and services 8 Universal Release of Information Form for release or exchange of information for all private care providers

Referral Procedures and Timelines Following the receipt of parent signature for consent for an ERMHS Tier IIIII eligibility evaluation the evaluation packet will be forwarded to the assigned ERMHS Clinician If for some reason the parent signature has not been obtained within 30 days of the initial request for consent the case manager will inform the districtIEP Team theeligibility evaluation cannot be started It is the responsibility of the case manager to reconvene an IEP to address the lack of parental consent to the proposed ERMHS Tier III eligibility assessment plan ERMHS Initial EligibilityEvaluation Upon receipt of parental consent for the ERMHS Tier III evaluation the case manager will schedule an IEP within 60 days consistent with legal requirements for other educational assessments (Transfer-in students from another SELPA with an active IEP with mental health services must be scheduled within 30 days) The ERMHSClinician will conduct an evaluation to determine if there is a socio-emotional problem negatively impacting the studentrsquos ability to benefit from hisher education If eligible the ERMHS Clinician will offer a recommendation ofrelated goals and service delivery The IEP team will be provided a copy of the ERMHS Clinicianrsquos report and recommendations will be proposed and discussed The mental health evaluation shall be designed to determine the studentrsquos need for mental health services that are necessary for the student to make educational progress The ERMHS Clinician shall review and consider current or previous educational reports observations of the student in the classroom and interviews with the student parent and teacher Other useful sources of information mayinclude physician psychiatrist social worker probation officer extended family and psychologist Consideration of relevant cultural issues native language environmental history and family history are essential to this assessment

Criteria for determining needs for services Assessment Standards


The assessment shall be designed to determine the students need for mental health services that are necessary for the student to make educational progress in the educational setting The assessment should include the followinginformation Documentation that the student exhibits emotional or behavioral characteristics symptoms that

Are observed by qualified educational staff in educational and other settings as appropriate Impede the student from benefiting from any special education services There must be a direct

relationship between the emotionalbehavioral characteristics and the lack of benefit from specialeducation services This may be shown by lack of progress on goalsobjectives grades standardized tests scores district assessments formal observations

Are identified significant as indicated by their rate of occurrence and intensity Are associated with a condition that cannot be described solely as a temporary adjustment problem that

can be resolved with less than three months of school counseling

Documentation of appropriate School Based Interventions (ie school based counseling guidance interventionsbehavior support plan FBAFAA) Documentation should include a description of the interventions considered and to what extend these interventions were successful Identify the specific lack of educational progress and how thisis directly related to the students mental health concerns Consideration of relevant cultural issues native language environmental history and family history is required as part of this assessment

Assessment Report The mental health eligibility evaluation shall culminate in a written report which will determine the studentrsquos need for mental health services in order to benefit from hisher special education The ERMHS Clinician and ERMHS School Psychologist will work together to insure standardized evaluation tools are utilized for the baseline functioning and each professional performs work within the scope of hisher license or certificate This written report will be completed within timelines to give the IEP team advance consideration prior to the next IEP meeting and include the following information

bull Identifying Information Name date of birth gender legal guardian with contact information LEA current classroom placement grade clinician name and license number date and referral sourcebull Statement of Language Consideration bull Reason for Referral Who and why bull Assessment methods Record review observation interviews summary of standardized testing used inthis assessment others bull Description of Mental HealthBehavioral Concerns (socio-emotional problem) Rate intensity for significance statement relationship of studentrsquos problem behaviors with academic achievement and how long the problem behavior has been occurring (to determine whether it is a temporary adjustment reaction) bull Relevant healthdevelopmentmedical findingshistory Summarize and consider outside reports when available such as DSM V diagnosis Previous mental health conditions psychiatric hospitalizations currentmedications bull Relevant Special Education History and Intervention History Past and current IEP servicesaccommodationsmodifications identified disability school-based interventions successes as well as discipline patterns Review of Behavior Intervention andor Direct Treatment Plans and effectiveness bull Present Levels of Academic Functioning Standardized scores goals objectives grades progress or lack of progress in these areas bull Summary of Interviews Parent teacher student service providers intervention providers


bull Summary of observations classroom and other settings as appropriate bull Summary of PsychologicalSocial-emotional-behavioraladaptive conditions Evidence based instruments are to be used in evaluation and when used a statement about test validity will be included Functional Behavior Analysis Profiler Child Behavior ChecklistCBCL (Achenbach) Behavior Assessment System forChildren (BASC) Connors Scale are examples but should not be limited to these instruments bull Determination of environmental cultural or economic factors which may impact the student bull Summary and Findings Is there a determined need for mental health services as a related service for the studentrsquos IEP in order for the student to benefit from education Is there a direct relationship between the emotional-behavioral problems and the lack of academic progress at a significant levelbull Recommendations for mental health services to be provided on IEP

Key ingredients of the psychoeducationalmental health evaluation include but are not limited to the following

A Reason for Referral (School PsychologistMental Health Clinician) State the person who made referral including referring school psychologist school and district This section of the report describes why the child is being referred for testing what problems the

student has had that warrant evaluation and the purposes of the assessment This part of the reportorients the reader to the reportrsquos contents and provides a framework for assessment findings

This should address how the school district believes the mental health issues affect current educational performance as well as school attendance

B Child History and Background Information (School PsychologistMental Health Clinician)

A psychoeducationalmental health assessment is essentially a ldquosnapshot in timerdquo It represents an appraisal of the studentrsquos current functioning against the backdrop of the studentrsquos past Therefore the psychologistclinician needs to obtain a thorough history of the student and include all relevant historicalinformation within the report

For students who may be in need of special education services it is critical that the historical section of the report include all relevant medical history Information to be included consists of any pre- and perinatalfactors which may have a bearing on subsequent child development the studentrsquos acquisition of developmental milestones in accordance with a developmental timeframe the studentrsquos history of infection illness and injury and anecdotal observations regarding the childrsquos health and preschool development

Research has shown that various adverse pre-and perinatal factors may predispose the student to subsequent learning problems For example prematurity puts the child ldquoat riskrdquo for later problems with language and other forms of information processing Adverse reactions to vaccines the experience of frequent or chronic earinfections seizure disorder attention deficit social andor emotional difficulties surgeries and strep infection can provide important clues regarding the ldquorisk factorsrdquo that may predispose the student to subsequentlearning disabilities

Historical information should also include data regarding the studentrsquos development of fine and gross motor skills demonstration of facility in speech and language function ability to interact play and socialize with peers and the timeline for accomplishment of developmental milestones

The historical section of the report should also contain a complete review of the studentrsquos educational history beginning with preschool educational experiences and concluding with the studentrsquos present educational


placement Therefore it is critical that the psychologistclinician obtain a complete educational record for the child to include all report cards anecdotal records standardized test results teach and parent observationsand the results of prior evaluations Whenever possible psychologistsclinicianrsquos should seek to obtain actual test scores and not just written summaries from previously completed assessments

It is important to include in the historical section of the report observational data from individuals who havehad an opportunity to interact with the child over time This includes teachers parents and other professionals who can provide important insight into the childrsquos functioning in a variety of settings and the studentrsquos progress (or lack of it) over time

For the student with a prior history of evaluation particular attention should be paid to how the child has tested over time IT is not unusual for students who receive appropriate educational programs to demonstrate growth not only on standardized academic achievement tests but also on measures of cognitive functioning

The historical section of the report should take the reader from the beginning of the studentrsquos life and leave the reader right at the point where the assessment begins This sets the stage for the occurrence of the ldquosnapshot in timerdquo

C Child Behavior during Testing (School PsychologistMental Health Clinician)

Behavioral observations of the student under standardized test conditions are critical to the compilation of the psychoeducationalclinical assessment report It is not only important how the student tests in terms of scores but what the student does during the process of the evaluation Whether the child is attentive or inattentive hyperactive or hypoactive has good or poor rapport with the examiner has an impulsive or methodical response style or is motivated or unmotivated to complete the testing tasks is crucial to interpreting theobtained test results

Some children with special needs are extremely difficult to test Their problems with attention concentration impulse control and limited frustration tolerance can create continual interferences during the testing process and may compromise the reliability and validity of the obtained test scores If negative behaviors are observed during testing these should be reported by the examiner and obtained test scores should be interpreted with extreme caution

On the other hand many children are extremely hard working and motivated to do well during testing Theyput forth an extraordinarily strong amount of effort which contributes to the reliability and validity of obtained test results These behaviors should be interpreted with extreme caution

Often test scores obscure the process behind the studentrsquos test-taking behavior and may obscure the truth of the childrsquos functioning rather than reveal it The concept of reporting qualitative data rather than just quantitative data in an evaluation is referred to as ldquoprocess assessmentrdquo The term ldquoprocess assessmentrdquo comesfrom the saying ldquoit is not whether you win or lose but how you play the gamerdquo How the student obtains the test scores is just as critical if not more critical than the actual scores themselves Therefore both qualitative and quantitative information is critical to the compilation of the psychoeducational evaluation report

D Test Results and Analysis (School PsychologistMental Health Clinician)

In this section of the report the psychologistclinician presents all relevant information obtained during testing and analyzes and interprets test results This is a critical section of the report which gives the


psychologist and clinician the opportunity to discuss and interpret both the quantitative and qualitative information obtained during the course of the assessment

If prior testing was accomplished or if the child has been receiving special education this section of the reportshould include information as to whether the child is making a reasonable degree of educational progress and whether the child is benefiting from specially designed instruction and educational intervention

E Summary of Test Results and Recommendations for Intervention (School PsychologistMental Health Clinician)

The final section of the psychoeducationalclinical assessment contains a summary of test results and the recommendations for intervention This section should contain not only an overview of all major test findingsbut also a determination of the childrsquos eligibility for special education services if it is an initial evaluation In essence this section of the report provides a blueprint for the writing of the studentrsquos IEP

Areas that the School Psychologist and Mental Health Clinician may want to assess together include the following

1 Observational Data Collection An important component of the assessment includes observational data regarding the childrsquos functioning in the classroom in structured and unstructured social situations and athome (per report of the parent) It is important for the assessors to observe themselves it is also important to obtain data directly from individuals who have frequent and ongoing contact with the student in avariety of settings It is also very important to collect observational information from parents as they should know their child the best Parents have had the opportunity to observe the child from birth until the present time Parents are ldquoin the trenchesrdquo with their child from one school year to the next and have the ability to observe the childrsquos strengths and weaknesses in a variety of sessions over a lifetime Parents are also able to provide input to the assessors about how the student has progressed through the grades andhow the student interacted with the various teachers and staff members They have the opportunity to observe the studentrsquos ability to complete homework in an independent setting They are also more likely to see the results of fatigue and frustration at the end of the day Finally it is important to collectobservational input from the other staff members working with the student such as the Counselor Behaviorist Occupational Therapist Physical Therapist Speech and Language Therapist Playground Aides Bus Drivers and many others

2 Measures of Personality Functioning This is an area with the purpose of understanding the childrsquos personality The orientation of the personality is critical to determining the variables that may affect the childrsquos academic performance at school Some students may have profound and serious learning problemsbut because of the nature of their personality present as very hardworking students who manage to accomplish a great deal against sizable odds Other students may experience very mild learningimpairments but as a result of temperament and personality experience a great deal of distress about their learning Therefore assessment of personality functioning is a critical component of the assessment

3 Tests of Attention and Executive Functioning Testing of attention and executive functions becomes rather complex because there are no single test measures that effectively ascertain functioning within thesedomains Therefore the assessors must create a battery of tests and checklists which provide both anecdotal information and objective evidence of the studentrsquos ability to attend concentrate control impulsivity and engage higher level executive functioning


IEP Goals Mental Health based IEP goals should initially be written for a 6-12 session period The ERMHS provider shouldwrite the goal(s) with participation of the student if possible to achieve a greater level of ldquobuy inrdquo IEP team must reconvene to review goals after data is collected to document the studentrsquos baseline Additionally after the determined number of sessions is complete and data is collected the team must reconvene to determine if theservice is needed for a longer duration greater or lesser frequency is needed a greater or lesser amount of minutes is needed or if a new goal is needed Flexibility and age appropriate based services should be considered whenrecommending the frequency and duration of services

Progress Monitoring Like any other service or goal progress monitoring is vital It will determine the need for continuing the goalservice beyond the IEP specified time period When monitoring IEP goals it is extremely important to includeaccurate data in the progress updates

ERMHS TIER IIIII Exit Criteria In the event a studentrsquos functioning stabilizes (over a three month period consistent educational goal achievement general adaptive functioning improvement and ERMHS Clinician recommendation) the student will be re-evaluated for exit from service(s) To be eligible for exit interventions must be completed student must have an acceptable level of stability and the student must have adequate community or school resources including a receiving site so heshe can continue to benefit from the special education program and services Recommendations for changes or exit from ERMHS services are made by the ERMHS Clinician Changes to IEP related services shall be addressed in an IEP meeting Changes require parental consent

HIPAAFERPA

I Introduction The purpose of this guidance is to explain the relationship between the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule and to addressapparent confusion on the part of school administrators health care professionals and others as to how these two laws apply to records maintained on students It also addresses certain disclosures that are allowed withoutconsent or authorization under both laws especially those related to health and safety emergency situations While this guidance seeks to answer many questions that school officials and others have had about the intersection of these federal laws ongoing discussions may cause more issues to emerge Contact information for submittingadditional questions or suggestions for purposes of informing future guidance is provided at the end of this document The Departments of Education and Health and Human Services are committed to a continuing dialogue with school officials and other professionals on these important matters affecting the safety and security of our nationrsquos schools

II Overview of FERPA FERPA is a Federal law that protects the privacy of studentsrsquo ldquoeducation recordsrdquo (See 20 USC sect 1232g 34 CFR Part 99) FERPA applies to educational agencies and institutions that receive funds under any programadministered by the US Department of Education This includes virtually all public schools and school districts


and most private and public postsecondary institutions including medical and other professional schools If an educational agency or institution receives funds under one or more of these programs FERPA applies to the recipient as a whole including each of its components such as a department within a university See 34 CFR sect 991(d) Private and religious schools at the elementary and secondary level generally do not receive funds fromthe Department of Education and are therefore not subject to FERPA Note that a private school is not made subject to FERPA just because its students and teachers receive services from a local school district or State educational agency that receives funds from the Department The school itself must receive funds from a program administered by the Department to be subject to FERPA For example if a school district places a student with a disability in a private school that is acting on behalf of the school district with regard to providing services to thatstudent the records of that student are subject to FERPA but not the records of the other students in the private school In such cases the school district remains responsible for complying with FERPA with respect to theeducation records of the student placed at the private school An educational agency or institution subject to FERPA may not have a policy or practice of disclosing the education records of students or personally identifiable information from education records without a parent or eligible studentrsquos written consent See 34 CFR sect 9930 FERPA contains several exceptions to this general consent rule See 34 CFR sect 9931 An ldquoeligible studentrdquo is a student who is at least 18 years of age or who attends a postsecondary institution at any age See 34 CFR sectsect 993and 995(a) Under FERPA parents and eligible students have the right to inspect and review the studentrsquos education records and to seek to have them amended in certain circumstances See 34 CFR sectsect 9910 ndash 9912 and sectsect 9920 ndash 9922 The term ldquoeducation recordsrdquo is broadly defined to mean those records that are (1) directly relatedto a student and (2) maintained by an educational agency or institution or by a party acting for the 1 agency or institution See 34 CFR sect 993 At the elementary or secondary level a studentrsquos health records includingimmunization records maintained by an educational agency or institution subject to FERPA as well as records maintained by a school nurse are ldquoeducation recordsrdquo subject to FERPA In addition records that schools maintain on special education students including records on services provided to students under the Individuals with Disabilities Education Act (IDEA) are ldquoeducation recordsrdquo under FERPA This is because these records are (1) directly related to a student (2) maintained by the school or a party acting for the school and (3) not excludedfrom the definition of ldquoeducation recordsrdquo At postsecondary institutions medical and psychological treatment records of eligible students are excluded from the definition of ldquoeducation recordsrdquo if they are made maintainedand used only in connection with treatment of the student and disclosed only to individuals providing the treatment See 34 CFR sect 993 ldquoEducation recordsrdquo These records are commonly called ldquotreatment recordsrdquo An eligible studentrsquos treatment records may be disclosed for purposes other than the studentrsquos treatment providedthe records are disclosed under one of the exceptions to written consent under 34 CFR sect 9931(a) or with the studentrsquos written consent under 34 CFR sect 9930 If a school discloses an eligible studentrsquos treatment records for purposes other than treatment the records are no longer excluded from the definition of ldquoeducation recordsrdquo and are subject to all other FERPA requirements

The FERPA regulations and other helpful information can be found at httpwwwedgovpolicygenguidfpcoindexhtml

IV Where FERPA and HIPAA May Intersect When a school provides healthcare to students in the normal course of business such as through its health clinic it is also a ldquohealth care providerrdquo as defined by HIPAA If a school also conducts any covered transactions electronically in connection with that healthcare it is then a covered entity under HIPAA As a covered entity the school must comply with the HIPAA Administrative Simplification Rules for Transactions and Code Sets and Identifiers with respect to its transactions However many schools even those that are HIPAA covered entities are not required to comply with the HIPAA Privacy Rule because the only health records maintained by the school are


ldquoeducation recordsrdquo or ldquotreatment recordsrdquo of eligible students under FERPA both of which are excluded from coverage under the HIPAA Privacy Rule See the exception at paragraph (2)(i) and (2)(ii) to what is consideredldquoprotected health informationrdquo (PHI) at 45 CFR sect 160103 In addition the exception for records covered by FERPA applies both to the HIPAA Privacy Rule as well as to the HIPAA Security Rule because the Security Rule applies toa subset of information covered by the Privacy Rule (ie electronic PHI)

Information on the HIPAA Privacy Rule is available at httpwwwhhsgovocrhipaa Information on the otherHIPAA Administrative Simplification Rules is available at httpwwwcmshhsgovHIPAAGenInfo

Family Educational Rights and Privacy Act (FERPA) and California Education Code sectsect 49073 et seq

The Family Educational Rights and Privacy Act (FERPA) (20 USC sect 1232g 34 CFR Part 99) is a Federallaw that protects the privacy of student education records The law applies to all schools that receive funds under an applicable program of the US Department of Education Similarly California Education Code sections 49073 et seq is the state law governing privacy of pupil records FERPA and the corresponding provisions of the Cal Education Code give parents certain rights with respect to their childrens education records These rights transfer to the student when he or she reachesthe age of 18 or attends a school beyond the high school level Students to whom the rights have transferred are eligible students

Parents or eligible students have the right to inspect and review the students education records maintained by the school Each district must have a procedure for parents or eligible students to request copies of the pupil records and schools may charge a reasonable fee for copies Requested access to pupil records must be granted no later than five business days following the date of the request (EC 49069)

Parents or eligible students have the right to request that a school correct records which they believe to be inaccurate or misleading If the school decides not to amend the record the parent or eligible student then has the right to a formal hearing After the hearing if the school still decides not to amend the record the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information (Education Code 49070 34 CFR 9920)

Generally schools must have written permission from the parent or eligible student in order to release any information from a students education record However the law allows schools to disclose pupil records without consent to the following parties or under the following conditions (Education Code 49076 34 CFR sect 9931)


School officials with legitimate educational interest - this includes a contractor or consultant who has a formal written agreement or contract with the district regarding the provision of services or functions outsourced to himher by the district

Other schools to which a student is transferring Specified officials for audit or evaluation purposes Appropriate parties in connection with financial aid to a student Organizations conducting certain studies for or on behalf of the school Accrediting organizations To comply with a judicial order or lawfully issued subpoena Appropriate officials in cases of health and safety emergencies Members of a school attendance review board (SARB) and State and local authorities within a juvenile justice system pursuant to specific State law

Schools may disclose without consent directory information such as a students name address telephone number date and place of birth honors and awards and dates of attendance pursuant to district policy However schools must tell parents and eligible students about directory information andallow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them Schools must notify parents and eligible students annually of their rights under FERPA The actual means of notification (special letter inclusion in a PTA bulletin student handbook or newspaper article) is left to the discretion of each school Legitimate interest is defined as the following per county counsel

ndashThe school official must have a ldquolegitimate educational interestrdquo in the information in order to access it under this exception

ndashThe US Department of Education has interpreted ldquolegitimate educational interestrdquo to mean that the official needs access in order to perform his or her professional duties (Need to know ndash not want to know)

For more information regarding this topic please visit wwwfamilypolicyedgov


Frequently Asked Questions (FAQrsquos)

Confidentiality of Educationally-Related Mental Health Records

1 When does FERPA apply and when does HIPAA apply As a general rule HIPAA requires health care providers to protect the confidentiality of ldquoindividually identifiable health informationrdquo and prohibits them from disclosing it or allowing others to access it without signedpermission from the patient or the patientrsquos personal representative Recognizing the sensitive nature of mental health therapy records in particular HIPAA provides even greater protection for what it terms ldquopsychotherapynotesrdquo

However the HIPAA Privacy Rule explicitly states that its rules do not apply to health information held in an ldquoeducation recordrdquo subject to FERPA In other words if FERPA applies the HIPAA Privacy Rule does not apply The term ldquoeducation recordsrdquo is broadly defined to mean records files documents and other material containinginformation directly related to a student that are maintained by a school or a person acting for the school (See 34 CFR sect 993)

2 I was trained in HIPAA why are you talking about FERPA FERPA allows schools and educational agencies to share information in a studentrsquos education record with ldquoschool officialsrdquo who have a ldquolegitimate educational interestrdquo in the information without parental consent The term ldquoschool officialrdquo includes school staff such as teachers health staff clerical staff school police andattorneys A school or district also may define this term more broadly so that it also includes the ability to share information with outside consultants or contractors to whom the school has outsourced a school function pursuantto a contract This is why the district is able to share student information with NPAs that provide student mental health services

3 What confidentiality requirements apply to notes of student counseling sessions The general rule is that any information of a personal nature disclosed by a pupil 12 or older in the process of receiving counseling is confidential (Ed Code sect 49602) This information may not become part of the pupil record without the written consent of the person who disclosed the confidential information There are exceptions including psychotherapist referrals for treatment reports of child abuse and disclosures to principals or parentsfor the health and safety of the student or the school community provided that such disclosures do not imperil the health and safety of the studentIn addition counselors may disclose personal information to law enforcement authorities pursuant to a court order

4 My districtrsquos contracted NPA wonrsquot let me have access to ldquotheirrdquo files what should I do Ideally the agreement between your district and the NPA would specify that any records created during these outsourced mental health services are student records that belong to the district If your districtrsquos contract with the NPA does not specify that the district ldquoownsrdquo these records you may need to explain that these are educational records The NPA only has access to the students through its contractual relationship with the district Under both FERPA and the California Education Code there is an exception that authorizes contractors or consultants to access otherwise confidential education records As noted above Education Code section 49076(a)(2)(G)(i) and 34 CFR 9931 state that a school district may release information from pupil records to a contractor or consultant with a legitimate educational interest who has a formal written agreement or contract


with the school district regarding the provision of outsourced institutional services or functions by the contractor or consultant

Here districts contract with NPAs to provide services to students that they would otherwise provide themselves pursuant to Education Code section 49600 which authorizes districts to offer a structured coherent and comprehensive educational counseling program These mental health services have an educational purpose otherwise districts would not be able to pay for the services with school funds Thus the records resulting from those services which are provided and funded for educational purposes belong to the district and not the NPA

5 What if the parent signs the IEP for mental health services but does not sign the consent form If a minor is 11 years old or younger consent by a parentguardian is required before providing the minor withoutpatient mental health counseling or treatment services Family Code 6920-6929 and Health and Safety Code 124260 allow a minor age 12 or older to consent to outpatient mental health counseling or treatment services without parentguardian consent if in the opinion of a schoolpsychologist or other professional person as defined the minor is mature enough to participate intelligently in the services However the childs parentguardian must still be involved unless the professional person determines it would be inappropriate

If the parent signs the IEP but refuses to sign the authorization to provide mental health services the district is still obligated to provide the services set forth in the IEP If the student is 12 or older and consents to mental health services parental consent is not required and the district should go ahead and provide the mental health servicesagreed to in the IEP If the student is 11 or younger the district may need to file for due process to resolve the conflict between the agreed-upon offer of FAPE and the refusal to consent to mental health services

6 What if the parent signs consent for treatment but not the IEP If a parentguardian signs consent for treatment but not the IEP the parent should reference the notes page where it is recommended that the team have a conversation about the difference between the mental health consent form and the signature page which allows for consent to implement the IEP It is recommended that the conversationand documentation include that the educationally related mental health service will be begin once the IEP document is signed If there is disagreement in any area the team should reconvene to discuss any issues relating to the IEP in order to gain consent from the parentguardian to implement the IEP


Top Five components and facts to consider when creating a Mental Health Program 1 It is extremely important to map out the districts tiered system of support which includes Behavioral

Health Recovery Services (BHRS) The tiered approach model incorporates evidence based practices for Pre-Referral (Social Emotional Curriculum) Tier 1 (Universal prevention and intervention strategies) Tier2( Selected targeted interventions) and Tier 3 (intensive need interventions) Please see the following for an example with the understanding models vary from district to district

Pre-referral School Counselors or Social Emotional Learning

Curriculum

Tier 1 School Psychologists

Tier 2 In house Mental Health

Team

Tier 3 BHRSNPANPS

2 SELPA does not reimburse 100 of Mental Health employee salaries We usually reimburse UP TO 75 of the total mental health based employment dependent upon the job description and duties This reimbursement is directly tied to the district allocation for mental health funding as well as the allowable expenditures in the Mental Health Grant Districts should be mindful of staying within their allocated funds unless they expect to contributeextra monies at the end of the fiscal year

3 Please do not forget that when building a Mental Health Team districts should be thinking about all aspectsof the program such as a qualified staff member policies and procedures to access Mental Health Services required versus desired paperwork protocols district specific tiered level of interventions and internal policies andprocedures

4 Make sure to meet with a SELPA member to ensure proper understanding of reimbursable vs non reimbursable items your specific mental health entitlements and proper documentation of these specific itemsPlease reference pages 37-45 in this document for examples

5 It is helpful to identify one mental health based point person such as a mental health coordinator school psychologist program specialist or coordinator etc in order to receive monthly information from the SELPA The SELPA will be hosting a monthly meeting to help ensure that policies procedures and funding guidelines are being understood and followed


nt meet referral cl1tcl1a Continue with lntNvcnUon Rcv1se supports Conildcr FAA

Not a1iprovcd

Spe(ial Eduaition sudent exhibiting emotional difficulties th1t are signifiamtly impacting hiher ability to benerit from l~P placement and services

l With assi51llnce from designee determine ii the referral is bchavioml or ment11 health dMven

l 1

Case Manager coordinates pre-referral

services to Include Develop or revise DIP Is approprlarc Collect Dara Consult 1~1h TcachersScrvtcc Providers

l At the BIP review tem will discuss interventions and if appropriate case manager ndor designet 1lt111 complete Menral Health Rubric

Eligible No Review placement intervenons and need for FAA

I

f

Does mett referral crlterla Psychologist sends referral 10 spidal education dlrtctor or dcslgnee

Director or delg11ee approves asiesmenl plan amp release for exchange olinformation is signed by parent preferably at an IEP meeting

Assessment amducted by Mental Health A1essmentTeam

Mental llealth Asscsimem Team presents findings at IEP mcetlng lEP team determines ellglblllty for mental health servtce

1 Eligible Ycslmplernenl Services Consider a Direct Treatment Proto-1 instead of or in addition to a ~W

J If student requires a higher level or or greater continuum of service work 1~th tl1e director ordeslgnec 10 acquire DllRS scrvlm and or apmicrolOprlateness or placemen~

_I


Miscellaneous Mental Health Coding Definition and Guidelines

Approved Mental Health Vendors

On site mental health services at approved NPS

Placements

Approved Day Treatment Service

Vendors

1 Beacon

2 BHRS

3 Edgewood (Fee for Service)

4 StarVista

1 Achieve Kids 2 Beacon 3 Edgewood 4 Esther B Clark 5 Oak Hill School 6 Palo Alto Preparatory 7 Rise Institute

1 Beacon 2 BHRS 3 Edgewood 4 Esther B Clark

Service Location Codes

CODE Definition 610 Continuation School

510 Regular classroompublic day school 630 Juvenile Court School

520 Separate classroom in public integrated facility

640 Community School

540 Separate school or Special Education Center or Facility

810 Nonpublic Day School

550 Public Residential School 820 Nonpublic residential School in CA

560 Other public school or facility 830 Nonpublic residential school outside of CA

570 Charter School (operated by an LEAdistrict) 840 Private Day School not certified by the CDE

580 Charter School (operated as an LEA) 890 Service Provider Location

School Type Codes

CODE Description

70 Nonpublic Day School A nonpublic nonsectarian that enrolls the student with disabilities pursuant to an IEP and employs at least one special educator and certified by the CDE

71 Nonpublic Residential School A nonpublic nonsectarian school that enrolls students with disabilities pursuant to an IEP employs at least one special educator and certified by the CDE This school provides an education program at the same location where the student resides Located in CA

72 Nonpublic Residential School A nonpublic nonsectarian school that enrolls students with disabilities


76

pursuant to an IEP employs at least one special educator and certified by the CDE This school provides an education program at the same location where the student resides Located outside CA

Private Residential School (not certified by CDE) a school sectarian or nonsectarian which is not administered by a public agency and does not provide special education services The student resides at this school although private residential school may provide a combination of residential and day programs The status of a student (whether day or residential) will depend on where the student resides Services are through an ISP in accordance with district policy for serving students in private schools

CDE Directions on Coding Residential Placements Frequency and Duration

Residential Treatment Services Code (545) Mark residential services as ldquoDailyrdquo in ldquoFrequencyrdquo and 1440minutes under ldquoDurationrdquo as the service is by its nature provided 247 Any other mental health service received (ie counseling behavior intervention etc) in addition to the residential care service would reflect the specific frequency and duration of that service In the comments section it is recommended that a statement should be made about all related services are embedded within the Daily Residential Treatment Services Please see sample of a fictitious service page below

Sample Mock Service Page for Students who receive Residential Services

Service Residential Treatment Services Start Date 10212016 End Date 10202017

Provider District of Service Ind Grp Sec Transition

DurationFreq 1440 min X1 Totaling 1140 min served daily

Location Nonpublic residential school ndashin or outside of California

Comments Services provided by _____residential treatment center

Service Specialized Academic Instruction Start Date 10212016 End Date 10202017

Provider Nonpublic school (NPS) under contractwith SELPA or district

Ind Grp Sec Transition

DurationFreq X min X1 Totaling X min served daily

Location Nonpublic residential school ndashin or outside California


Service Individual Counseling Start Date 10212016 End Date 10202017


DurationFreq 60 min X1 Totaling 60 min served weekly


Comments Individual therapy services are embedded within the Daily Residential Treatment

Services

Service Counseling and Guidance Start Date 10212016 End Date 10202017


DurationFreq 120 min X1 Totaling 120 min served Weekly


Comments Group therapy services are embedded within the Daily Residential Treatment Services

Service Parent Counseling Start Date 10212016 End Date 10202017




Comments Parent counseling therapy services are embedded within the Daily Residential

Treatment Services

Comments Academic services are embedded within the Daily Residential Treatment Services


Documenting Educationally Related Mental Health Services on the IEP ERMHS

1 ERMHS Services within District

IEP Form Annual Goals The IEP includes at least one goal that is addressed by ERMHS Best practice is to have

annual goal addressed by ERMHS includes benchmarks or short term objectives If the student takes an alternate assessment (ie CAA) the annual goal addressed by

ERMHS must include benchmarks or short term objectives

IEP Form Services-Offer of FAPE Service 510 Individual Counseling (if ERMHS assessment results include individual 11

counseling) Service 515 Counseling and Guidance (if ERMHS assessment report include group

counseling) Service 520 Parent Counseling (if ERMHS assessment report include parent counseling)

For each service listed above document the following Provider 410 Nonpublic School (NPS) under contract with the SELPA

400 Nonpublic Agency (NPA) under contract with the SELPA 300 Department of Mental Health 100 District of Service

Frequency DailyWeeklyMonthlyYearlyAny other frequency or as needed Duration MinutesSession _____

SessionsFrequency_____ Total Minutes Frequency_____

Start Date Enter the date which the services will start End Date Enter the date which the services will end Location 1 520 Separate classroom in public integrated facility

2 810 Nonpublic School under contract with SELPA 3 540 Separate school or Special Education Center or Facility 4 610 Continuation School 5 570 Charter School operated by an LEA 6 580 Charter School operated as an LEA

2 Nonpublic School

IEP Form Student Information Select the specific Nonpublic School

IEP Form Annual Goals


The IEP includes at least one goal that is addressed by ERMHS Best practice is to have annual goal addressed by ERMHS includes benchmarks or short term objectives

If the student takes an alternate assessment (ie CAA) the annual goal addressed by ERMHS must include benchmarks or short term objectives

IEP Form Services-Offer of FAPE (possible services) Service 330 Specialized Academic Services Service 415 Language and Speech Service 450 Occupational Therapy Service 510 Individual Counseling (if ERMHS assessment report include individual 11




400 Nonpublic Agency (NPA) under contract with the SELPA 300 Department of Mental Health100 District of Service


SessionsFrequency_____Total Minutes Frequency_____


2 810 Nonpublic School under contract with SELPA3 540 Separate school or Special Education Center or Facility 4 610 Continuation School 5 570 Charter School operated by an LEA6 580 Charter School operated as an LEA

IEP Form Educational Setting District of Service Enter the name of the district School of Attendance Enter Nonpublic School under contract with SELPA School Type 70 Nonpublic Day School Federal Setting 450 Day School

3 Day Treatment (Only Serramonte is approved)

IEP Form Student Information Select the Serramonte School





IEP Form Services-Offer of FAPE (possible services) Service 330 Specialized Academic Services (Make sure to include in the comments

section that the service is EMBEDDED in the Therapeutic Day School Day TreatmentProgram)

Service 415 Language and Speech Service 450 Occupational Therapy Service 510 Individual Counseling (if ERMHS assessment report include individual 11


counseling) Service 520 Parent Counseling (if ERMHS assessment report include parent counseling) Service 540 Day treatment Services

For each service listed above document the following Provider 300 Department of Mental Health

100 District of Service Frequency Weekly Duration MinutesSession_____



2 810 Nonpublic School under contract with SELPA 3 540 Separate school or Special Education Center or Facility4 610 Continuation School 5 570 Charter School operated by an LEA6 580 Charter School operated as an LEA

IEP Form Educational Setting District of Service Enter the name of the district School of Attendance Serramonte High School School Type 10 Public Day School Federal Setting 450 Separate School

4 Residential Treatment

IEP Form Student Information Select the specific Residential Facility under contract with SELPA







counseling) Service 520 Parent Counseling (if ERMHS assessment report include parent counseling) Service 545 Residential Treatment Services (1440 minutes served daily)


400 Nonpublic Agency (NPA) under contract with the SELPA Frequency DailyWeeklyMonthlyYearlyAny other frequency or as needed Duration MinutesSession _____




IEP Form Educational Setting District of Service Enter the name of the district School of Attendance Enter the name of the NPS under contract with SELPA School Type 71 or 72 Nonpublic residential school -in or outside of California Federal Setting 460 Residential Facility

5 Sample Harmful Effects Statements on the Offer of FAPE Potential Harmful Effect - The Code of Federal Regulations states the following sect 300552

Placements In determining the educational placement of a child with a disability including a preschool child

with a disability each public agency shall ensure thatmdash (a) The placement decisionmdash (1) Is made by a group of persons including the parents and other persons knowledgeable about

the child the meaning of the evaluation data and the placement options and


(2) Is made in conformity with the LRE provisions of this subpart including sectsect 300550ndash300554 (b) The childrsquos placementmdash

(1) Is determined at least annually (2) Is based on the childrsquos IEP and

(3) Is as close as possible to the childrsquos home (c) Unless the IEP of a child with a disability requires some other arrangement the child is

educated in the school that he or she would attend if nondisabled (d) In selecting the LRE consideration is given to any potential harmful effect on the child

or on the quality of services that he or she needs and (e) A child with a disability is not removed from education in age-appropriate regular

classrooms solely because of needed modifications in the general curriculum

Discussion Guidelines for Completing the Service Options and Harmful Effect Section of the IEP

Service Options

The service options that were considered by the IEP team (list all)

This section is intended for the IEP team to discuss and document service delivery options considered for the student The team must first consider placement in the general education classroom with supports prior to recommending a more restrictive setting all or part of the day There should be explicit reference to the upper and lower range of services considered for the student and includes reference to general education discussed for all students

Follow the continuum of services below as a guide to determining LRE

General Education Class General Education Class ndash Supplemental aids andor related services General Education Class ndash Some direct instruction by special education staff General Education Class ndash with some portion of the instructional day in a separate classroom Someor no instruction in General Education Class ndash Significant portion of the instructional day

in a separate classroom (intensive services) Special day school ndash Separate facility (public or nonpublic) with no general education students

on campus Residential School Hospital Program Home Instruction

Examples

The IEP team discussed the following educational placements general education with supplemental aides and services


general education with related services general education with specialized academic instruction general education with specialized academic instruction and related services specialized academic instruction for the majority of the school day with related services

The IEP team determined that the appropriate educational setting is _____

After reviewing school records teachers reports parents input and STUDENT present levels of performance the team discussed the following placement options general education setting with and without related services academic support and the self-contained academic instruction program The general education program with no special education supports was deemedinappropriate as this program does not provide enough support to meet STUDENT educational needs due to deficits in the area of XX The academic instruction setting emphasizing structure specialized instruction and smaller class size was deemed to be inappropriate because STUDENT is being successful in his current general education setting STUDENT is currently passing all of his classes in the general education setting with minimal support The team considered resource and the team agrees that one period of resource support is the most appropriate placement to meet STUDENTrsquos academic needs

The following services were considered for STUDENT general education academic support program and the academic instruction (academic and behavior) program The general education and the academic support program will not provide enough support for STUDENT at this time Theacademic instruction (academic) setting also will not provide enough support for STUDENT due to his emotional needs The academic instruction (with behavior and mental health supports) program will continue to be the most appropriate setting for STUDENT to support behavior and emotional needs STUDENT will also continue to receive related services (Counseling)

Harmful Effects

In selecting LRE describe the consideration is given to any potential harmful effect on the child or on the quality of services that he or she needs This section is intended for the IEP team to discuss and document any POTENTIAL harmful effects of the placement and services discussed in the section above

Some examples of harmful effects include decreased access to the instructional opportunities available in integrated settings decreased access to instructional opportunities with typical peers decreased opportunities for appropriate social interactions with typically-developing peers potential negative impact to studentrsquos self-esteem limited access to peers in the home community since placement is not located at the studentrsquos

school of residence decreased opportunities for appropriate social interactions with typically-developing peers


Some examples may include

IEP team discussed the following potential harmful effects of this placement -

decreased access to instructional opportunities with typical peers potential negative impact to studentrsquos self-esteem limited access to peers in the home community since placement is not located at the studentrsquos

school of residence

IEP team does not believe there will be any significant harmful effects and determined ____rsquos needs outweigh any minimal harmful effects at this time

IEP team discussed the following potential harmful effects of this placement - decreased access to instructional opportunities with typical peers potential negative impact to studentrsquos self-esteem

The IEP team agrees the impact of these above potential harmful effects are minimal and do not outweigh the need for services at this time

Residential treatment services (board and caremental health)- Vendors with Master Contracts

Residential treatment services including board and care and mental health services are the most easily identifiable mental health services to be considered allowable under the mental health grant As long as the vendor has a master contract with SELPA SELPA will pay the vendor directly for board and care costs and mental health costs Any costs that are considered solely educational costs such as costs for the school portion of the day are not considered reimbursable

Wraparound services provided through BHRS or Edgewood

Currently SELPA School Based Mental Health Guidelines has set the SELPA policy to indicate SELPA wide support for SELPA payment for any student who is determined to be eligible for Wraparound services Wraparound services is a set of coordinated support and intervening services offered through Behavioral Health and Recovery Service and Edgewood Center It is not a specific IEP service and the IEP team should take care to specifically document the coordinated activities that they believe should be occurring to support the school based and educational needs of the student These services are invoiced directly tothe SELPA


SELPA Purchase Order = LEA ISA

Just like at the district level in order for SELPA to pay a vendor we must generate a Purchase Order In order for SELPA to generate a purchase order we must know that the expense exists SELPA willautomatically open a blanket Purchase Order for the 4 agencies that participated in the RFP process along with POrsquos for any residential treatment centers and NPS agencies with whom we believe we have continuing student placements To ensure sufficient authorization on each PO SELPA will be requesting each LEA who places a student at an NPS Residential Facility or who utilizes the service of any vendor who is being paid directly by SELPA to generate a mental health specific Individual Service Agreement specifying the type duration and frequency of authorized Mental Health Services along with the copy ofthe IEP services page to be submitted to SELPA It is imperative that communication about placements changes in placements initiation of placements and cessation of placements be made to SELPA so that we can initiate and generate appropriate POrsquos here at the SMCOE business department

Mental Health Allowable Expenditures ndash Updated February 2017

The following is meant to provide guidance and support to LEAs when considering how to include the direct services they provide to students on fiscal reporting documents to the SELPA for Expenditure Reporting that SELPA can submit to CDE CDE general guidance is that the closer expenditures are to the direct provision of school-based mental health and other educationally related mental health services to students with IEPs the more allowable the cost can be considered

State Funds

Pursuant to Assembly Bill (AB) 114 funds must be used for

educationally related mental health services including out-of-home residential services for emotionally disturbed pupils required by an individualized education program pursuant to the federal Individuals with Disabilities Education Act (IDEA) of 2004 (20 USC Sec 1400 et seq) and as described in Section 56363 of the California Education Code (EC)

These provisions have been assigned Resource Code 6512 which differentiates these funds from Resource Code 6500 special education general fund programs

Federal Funds

Pursuant to AB 114 funds shall be available only for the purpose of providing

educationally related mental health services including out-of-home residential services for emotionally disturbed pupils required by an individualized education program pursuant to the federal IDEA of 2004 (20 USC Sec 1400 et seq) and as described in Section 56363 of the EC


Definition of Educationally Related Mental Health Services

As noted in the provisions above educationally related mental health services are described in 30 EC Section 56363 Section 56363 defines the term ldquodesignated instruction and servicesrdquo to mean ldquorelatedservicesrdquo as that term is defined in Section 1401(26) of Title 20 of the United States Code and Section 30034 of Title 34 of the Code of Federal Regulations (CFR)

Related services under IDEA are defined in Section 30034 of Title 34 of the CFR

Related services means transportation and such developmental corrective and other supportive services as are required to assist a child with a disability to benefit from special education and includes speech-language pathology and audiology services interpreting services psychological services physical andoccupational therapy recreation including therapeutic recreation early identification and assessment of disabilities in children counseling services including rehabilitation counseling orientation and mobility services and medical services for diagnostic or evaluation purposes Related services also include school health services and school nurse services social work services in schools and parent counseling and training (34 CFR 30034(a))

Section 30034 of Title 34 of the CFR further defines individual related services terms The following list represents some of the services that may be appropriate when addressing the mental health needs of students with disabilities

Code Category Title Ed Code Definition

510 Individual Counseling One-to-one counseling provided by a qualified individual pursuant to an IEP Counseling may focus on aspects such as educational career personal or be with parents or staff members on learning problems or guidance programs for students Individual counseling is expected to supplement the regular guidance and counseling program (34 CFR sect 30024(b) (2) (CCR Title 5 sect 30519)

515 Counseling and Guidance

Counseling in a group setting provided by a qualified individual pursuant to an IEP Group counseling is typically social skills development but may focus on aspects such as educational career personal or be with parents or staff members on learning problems or guidance programs for students Individual counseling is expected to supplement the regular guidance and counseling program (34 CFR sect 30024(b)(2) (CCR Title 5 sect 30519) Guidance servicesinclude interpersonal intrapersonal or family interventions performed in an individual or group setting by a qualified individual pursuant to an IEP Specific programs include social skills development self-esteem building parent training and assistance to special education students supervised by staff credentialed to serve special education students These services are expected to supplement the regular guidance and counseling program (34 CFR sect 30006 CCR Title 5 sect 30519)

520 Parent Counseling Individual or group counseling provided by a qualified individual pursuant to an IEP to assist the parent(s) of special education students in better understanding and meeting their childrsquos needs may include parenting skills or other pertinent issues IEP required parent counseling is expected to supplement the regular counseling and guidance program (34 CFR sect30031 (b)(7) CCR Title 5 sect 305113)

865 Case ManagementBrokerage (only for BHRS)

Service coordination and case management that facilitates the linkage of individualized education programs under this part and individualized family service plans under part C with individualized service plans under multiple Federal and State programs such as title I of the Rehabilitation Act of 1973 (vocational rehabilitation) title XIX of the Social Security Act (Medicaid) and title XVI of the Social Security Act (supplemental security income) 34 CFR sect 613


Refer to 34 CFR Section 30034 for the complete list of individual related services terms Residential placement is not listed as a related service in Section 30034 of Title 34 of the CFR However residential placement is addressed elsewhere in the IDEA

If placement in a public or private residential program is necessary to provide special education and related services to a child with a disability the program including non-medical care and room and board must be at no cost to the parents of the child (34 CFR 300104)

In addition the list of related services in the IDEA is not exhaustive or finite The individualized education program (IEP) team must decide what related services are necessary to provide a free appropriate public education (FAPE) to each student with a disability

Mental Health Provider Information

1 What do you need to know as an LEA if you want to hire a contracted Mental Health Provider

If you are an LEA you will need to notify San Mateo County SELPA of your potential provider before signing a contract SELPA will need to meet with the potential provider and review all grant funding language the mental health handbook policy and procedure The potential provider will need to be approved by San Mateo County SELPA if the LEA is seeking reimbursement from their mental health allocation If the provider is an approved provider on the Master Contract all invoices for appropriate services can be sent directly to the San Mateo County SELPA and will be paid for on a monthly basis If the provider is NOT on the Master Contract the district must first pay the invoices and seek reimbursement if eligible at the end of the year

2 What do you need to know if you want to be a contracted Mental Health Provider for an LEASchool District

If you wish to be a contracted Mental Health Provider for a LEASchool District you must first meet with and be approved by the San Mateo County SELPA The purpose of the meeting is to ensure that the provider has the appropriate experience background and understanding of the San Mateo County SELPA mental health policies and procedures as well as to determine if application as an NPA would be appropriate or necessary The Mental Health Handbook will be reviewed with the provider and a consistent meeting time will be set up with the point person at the SELPA The meeting will help toensure quality consistency and continuity of care Finally the master contract will be reviewed and it


will be explained that if the provider is an approved provider on the Master Contract all invoices with appropriate services can be sent directly to the San Mateo County SELPA and will be paid for on a monthly basis If the provider is NOT on the Master Contract the district must first pay the invoices andseek reimbursement if eligible at the end of the year

Frequently Asked Questions

What limitations are on the use of state and federal funds provided for educationally related mental health services

The legislature was clear that these funds are targeted for related services and that the funds are made available to SELPArsquos to provide services formerly provided by the County Mental Health agencies and the Department of Social Services The funds cannot be spent on educational services that have historically been provided by LEAs for students with emotional or behavioral needs ndash such as teachers ABA services behavioral support services or other educational support services

What are allowable uses of the state and federal funds due to the term ldquoeducationally related mental health servicesrdquo

Portions of salaries of certificated staff and classified providing direct mental health services and clericaltechnical and office staff salaries associated with administering related services for students with mental health needs In San Mateo County SELPA we have determined that most clericaloffice staff salaries will range between 1 ndash 5 maximum for processing of invoices and monitoring mental health invoicing For provision of direct mental health services andor providing direct supervision and coordination of mental health programs the maximum reimbursement request considered will be 75 of salaryexclusive of benefits and burdens

The room and board cost of residential placement if it is included in the studentrsquos IEP

Professional and consulting service (eg case management day treatment individual therapy family therapy group therapy group rehabilitation assessment psychological services and residential placement etc) costs for students with mental health needs

Transportation costs for a student to ensure a student receives related services from a provider This does not include transportation costs to and from a NPS or other school site where educational programs are provided Reimbursement for staffcontractors transportation to provide mental health services is not allowed

Approved mental health data collection and progress monitoring materials ndash ie Health Master or other progress monitoring resources approved by the SELPA


Further information to consider

1 For LEAs directly employing mental health professionals to provide related services

Mental health professionals such as clinical psychologists and marriage and family therapists are employed to provide services that are not authorized by credentials or other certifications issued by the CTC and instead are generally licensed by other state agencies such as the Office of Consumer Affairs In such cases these individuals would not be included in assignment monitoring conducted by county offices of education (COE) and the CTC However LEAs must ensure that such employees possess required licensure or training as established in state law All individuals employed to provide relatedservices must hold a valid credential issued by CTC with the appropriate authorization for those services or otherwise be authorized to provide services based on another section of statute or regulation and must be appropriately supervised All mental health services programs are considered Pupil Personnel Services Programs

Supervision

Individuals possessing an Administrative Services Credential are authorized to supervise and evaluate these personnel Given the specialized nature of the work of mental health professionals an administrator who has a background in providing related services such as a person dually-certified in Pupil Personnel Services and Administrative Services may be particularly well-suited to supervise these personnel but any holder of an Administrative Services Credential is authorized to supervise mental health professionals employed by an LEA

In addition Education Code Section 442702 allows the holder of a pupil personnel services credential to supervise a pupil personnel service program

ldquoAny person who administers a pupil personnel program shall hold a services credential with a pupil personnel or administrative specializationrdquo

Employers should note that pupil personnel services credentials do not authorize the holder to evaluate staff Caution should be used when determining who will supervise and evaluate staff

2 For LEArsquos contracting with community-based mental health professionals to provide related services

Community-based mental health professionals are broadly defined as any individuals licensed and assigned to provide mental health services that may be self-employed employed by a private agency or employed by a public agency such as a county mental health agency Individuals and entities that are employees contractors or vendors of these public agencies have been authorized to provide the specificservices to which they have been assigned and that authorization qualifies them to contract directly with LEAs to provide those same services When contracting with such individuals and entities LEAs should


ensure that they are currently contractors or vendors of the public agencies for the same related services for which the LEA is contracting Individuals and entities that are not current contractors or vendors of the public agencies described above must hold Nonpublic School (NPS) or Nonpublic Agency (NPA)certification in order to be eligible to provide related services (see below)

Supervision

In all cases community-based mental health professionals must be supervised in their school-based activities by an individual possessing a Pupil Personnel Services (PPS) Credential The term ldquosupervisedrdquo in this context means that the PPS credential holder has oversight of the school-based activities undertaken by a community-based mental health provider for the purpose of ensuring that these servicesare consistent with the needs of students served and are coordinated with other student services to allow for the provision of an efficient and comprehensive Pupil Personnel Services Program The requirement for community based service providers to be supervised by a PPS credential holder is established in Section 800491(c) of Title 5 California Code of Regulations which states

Nothing in this section shall be construed to preclude school districts from utilizing community-based service providers including volunteers individuals completing counseling-related internship programsand state licensed individuals and agencies to assist in providing pupil personnel services provided that such individuals and agencies are supervised in their school-based activities by an individual holding a pupil personnel services authorization

San Mateo County SELPA Specific Information

This list is not exhaustive and is subject to change and adjustment as new information comes forwardsuch as after audit findings or new legal guidance is released by CDE or the SELPA organization Each case should be considered for defensibility under auditndash in the end the mental health service must be provided to a student with an IEP that has mental health services listed on the IEP the reimbursable item or activity must be primarily for the support of the mental health service activity or student and it must be directly related to that IEP student or mental health service

Mental health books library resources software used for planning mental health treatment plansincluding CBT or other treatment planning tools online memberships to access treatment planning tools and data collection and progress monitoring tools related to mental health treatment such as Healthmaster Holdings LLC

Portions of salary of staff including school psychs qualified counselors mental health therapists etc ndash for the period of time that they are directly implementing the mental health portions of studentsrsquo mental health plans indicated in IEPs Our SELPA determination has been that the maximum allowable requested reimbursement to be considered will be 75 of the salary portion of qualified staff members who are providing documentable direct services excluding benefits and burdens

Portions of salary of clerical or other support staff excluding benefits and burdens who review invoices from NPSNPA agencies for accuracy attendance and who communicate with other agencies to ensure


that all students receiving mental health services accurately receive their services appropriately Approximately 1 - 5 has seemed typical across our SELPA

Portions of salary excluding benefits and burdens of the direct supervisoradministrative staffoverseeing the delivery and implementation of a mental health program Due to the state audit we have determined that portions of the salary of a Special Education Directorsupervisor are not recommended for reimbursement as these are educational expenses that the LEA previously provided and are therefore considered supplanted rather than supplemented reimbursement

What kinds of things are NOT recommended or eligible for reimbursement

Anything related to behavior ndash behavior coaching behavior support services ABA services servicesprovided by staff that have credentials licensure or certifications related to behavior support rather than mental health and any services that are not specifically listed on the IEP as mental health services

Consumable items such as food reinforcers like toys items that you would typically purchase for any classroom environment such as pens paper etc

Items that have dual purpose such that the mental health purpose is likely to not be the primary purpose for their use ndash ie bouncy chairs used for mental health distraction ndash these chairs will likely end up beingused often andor all day ndash this makes them not mental health chairs and more like OT chairs

Items that require too much explaining to make the connection to their mental health context ndash if you have to spend so much time explaining why it is connected to mental health then an auditor is likely not going to buy your story ndash ie ndash We needed all new computers for all staff and we use them only for mental health services and we never use them for email or going on the internet or writing reports about anything other than mental healthhellip)

Assessment tools that are not related to mental health exclusively ndash ie BASCs WISCs etc

Projectors for projecting movies that you are using as rewards for level systems

Refurbishment of an office to make it suitable for doing therapy in it

Travel for staff back and forth to other programs or to sites where students get mental health services or to deliver mental health services

Purchase of a vehicle to transport students to and from NPS where students get mental health services Transportation of students to their NPS ndash this is considered a regular portion of their educational program (Transporting a student to a separate mental health only service is allowed ndash ie if the student attends a mental health appointment or program after school at a separate site then transportation to and from that program could be covered)

Therapeutic dog or therapeutic dog training Nothing feline canine bovine porcine or equine at least in our SELPA


Benefits and Burdens ndash this finding is also related to the recent audit and is consistent with the issue of supplanting vs supplementing of prior funding Benefits and Burdens were a prior commitment of the LEA for internal staff and therefore the auditors found it suspect that reimbursement for these costs wasallowable

Indirect costs ndash SELPA and SMCOE are not charging indirect costs to the fund for their management of the grant and therefore no LEAs will be reimbursed for any indirect costs


Category Ed Code Definition Eligibility Title

Common Uses

I

Goals

510 Individual One-to-one counseling provided by a qualified individual etermined by IEP team after Counseling pursuant to an IEP Counseling may focus on aspects such as e completion of a Mental

educational career personal or be with parents or staff ealth Assessment members on learning problems or guidance programs for students Individual counseling is expected to supplement the regular guidance and counseling program (34 CFR sect 30024(b) (2) (CCR Title 5 sect 30519)

515 Counseling Counseling in a group setting provided by a qualified etermined by IEP team after and individual pursuant to an IEP Group counseling is typically e completion of a Mental Guidance social skills development but may focus on aspects such as ealth Assessment

educational career personal or be with parents or staff members on learning problems or guidance programs for students Individual counseling is expected to supplement the regular guidance and counseling program (34 CFR sect 30024(b)(2) (CCR Title 5 sect 30519) Guidance services include interpersonal intrapersonal or family interventions performed in an individual or group setting by a qualified individual pursuant to an IEP Specific programs include social skills development self-esteem building parent training and assistance to special education students supervised by staff credentialed to serve special education students These services are expected to supplement the regular guidance and counseling program (34 CFR sect 30006 CCR Title 5 sect 30519)

s recommendation from ssessment( all services to be elivered in an individual session) ndividual

ample Areas of Need Educational motion Regulation Coping Skills nger Management Anxiety

nterpersonal skills

The determined area of need is middotmp acting the students ability to ccess their educational setting ndor programming

s recommendation from ssessment (all services to be rovided in a group session either roup therapy or push in into a lassroom) roup ocial skills

ducational ie organizational skills motion Regulation oping Skills nter intra personal skills elf-Esteem building

-- - - - - -- - --

Goals As determined by IEP team mental health counselor

Please see goal examples for reference

Discontinuation documentation towards agreed upon goals When adding the service the team should agree and document what will constitute graduation from the service




520 Parent Individual or group counseling provided by a qualified etermined by IEP team after Counseling individual pursuant to an IEP to assist the parent(s) of special e completion of a Mental

education students in better understanding and meeting their ealth Assessment childs needs may include parenting skills or other pertinent issues IEP required parent counseling is expected to supplement the regular counseling and guidance program (34 CFR sect30031 (b)(7) CCR Title 5 sect 305113)

s recommendation from ssessment hort term to help parents nderstand the impact of their hilds disability and how to support em in the home with regards to e students academic

Goals No goals other than what is provided in the childs service

Discontinuation Team decision Likely when the student is making progress towards IEP goals and parents have a base level understanding of how to support them

rogramming

Mental Health Coding Cheat Sheet

SELPA Mental Health Handbook (updated 10317)

Duration frequency determined by ltheteam Not to be confused with Family rIherapy

540 Day Structured Education training and support services to Treatment address the students mental health needs (Health and Safety Services Code Div 2 Chap3 Article 1 1502 (a)(3))

545 Residential A 24-hour out-of-home placement that provides intensive Treatment therapeutic services to support the educational program Services (Welfare and Institutions Code Part 2 Chapter 25 Artsect

5671))

865 Case Service coordination and case management that facilitates the bull To ONLY be utilized by Manage men linkage of individualized education programs under this part BHRS for medi-cal tBrokerage and individualized family service plans under part C with billing purposes (only for individualized service plans under multiple Federal and State BHRS) programs such as title I of the Rehabilitation Act of 1973

(vocational rehabilitation) title XIX of the Social Security Act (Medicaid) and title XVI of the Social Security Act (supplemental security income) 34 CFR sect 613

510 or Consultatio Determined by JEP team Included in the individual Goals No goals 315 if nand after the completion of a counseling code [510] or

studen Collaboratio Mental Health Assessment counseling and guidance code Discontinuation Discontinues when mental health tonly n [515] For example if a student services end has receives 40 minutes weekly

one or individual or group counseling the services you could write a total of

other 60 minutes weekly In the notes servic spell out that this would include 40

e minutes weekly individual counseling and 20 minutes weekly consultation and collaboration between clinician and site in order to generalize learned skills

It is extremely important to list the right service provider on the service page Please use the list below for reference


Service Providers (Provider Agency) Code

Title Example

100 District Of Service Your District or District supervised subcontractor

300 BHRSBehavioral Health and Recovery Services

BHRS

400 Nonpublic Agency (NPA) under contract with the SELPA

Beacon Childrenrsquos Health Council Edgewood

SampleExample Mental Health Goals Avoiding Core Issues

Goal By_____ given direct instruction and 11 support student will replace her avoidance of dealing with core personal issues (sad affect verbal negative self talk and withdrawal into self) with compiling a notebook containing positive statements to self attributes she likes about herself (I am statements) positive activities she enjoys by herself and with others and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate in 4 out of 5 targeted observations

B1 By_____ given direct instruction in creating a positive ldquomerdquo book as well as guided practice in positive discussions of her strengths and strengths of others Student will develop a list of positive statements to self things she likes about herself (I am statements) positive activities she enjoys by herself and with others and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate She will complete a daily entry with staff support in 9 out of 10 targeted observations B2 By_____ given verbal prompts to use her ldquoMerdquo book containing her positive attributes student will complete the above activities daily and record in the day when she wanted to actually did avoid dealing with a problem (usually as a check out activity) in 9 out of 10 opportunities B3 By_____ student will initiate asking for and independently complete the above activities in her ldquoMerdquo book She will also engage in positive discussions about her strengths and the strengths of others when appropriate She will reflect on how she handled her anxiety throughout the day and what she can do better the next time within 4 out of 5 targeted observations

Avoiding Positive Comments Goal By_____ given direct instruction and 11 support Student will replace her avoidance of dealing with core personal issues (sad affect verbal negative self talk and withdrawal into self) with compiling a notebook containing positive statements to self attributes she likes about herself (I am statements) positive activities she enjoys by herself and with others and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate in 4 out of 5 targeted observations B1 By_____ given direct instruction in creating a positive ldquomerdquo book as well as guided practice in positive discussions of her strengths and strengths of others Student will develop a list of positive statements to self things she likes about herself (I am statements) positive activities she enjoys by herself and with others and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate She will complete a daily entry with staff support with in 9 out of 10 targeted observations B2 By_____ given verbal prompts to use her ldquoMerdquo book containing her positive attributes Student will complete the above activities daily and record in the day when she wanted to actually did avoid dealing with a problem (usually as a check out activity) in 9 out of 10 opportunities B3 By_____ Student will initiate asking for and independently complete the above activities in her ldquoMerdquo book She will also engage in positive discussions about her strengths and the strengths of others when appropriate


She will reflect on how she handled her anxiety throughout the day and what she can do better the next time in 4 out of 5 targeted observations

Conversational Skills Goal By___ given direct instruction 11 role playing scenarios social scripts and visual cues Student will replace avoiding eye-contact during conversation quoting TVmoviesbooks talking to herself interrupting othersrsquo conversations and waiting for others to approach her with making eye-contact during conversation initiating interactions with age-appropriate questionstopics or waiting for a break in conversation before entering it actively listening and assertively initiating positive peer interactions with 80 consistency in 45 observational periods

B1 By___ when given direct instruction role-playing scenarios and social scripts and visual cues for approaching others and initiating conversation Student will 1) identify and create a list of topics that are age-appropriate 2) use social scripts to practice assertively initiating sustaining and concluding age-appropriate conversations and making eye contact and 3) practice active listening by paraphrasing in her own words what staff has said with 90 consistency in 45 instructional sessions B2 By___ when given pre-correction social scripts and visual cues for approaching others and initiatingconversation Student will 1) use taught social scripts to practice assertively initiating sustaining and concluding age-appropriate conversations and making eye contact and 2) practice active listening by paraphrasing in her own words what peers have said in structured situations with 90 consistency in 45 instructional sessions B3 By ___ given social scripts taught above and 1-2 verbalnon-verbal prompts from staff Student will wait for a natural break in conversation and then use taught positive verbal scripts andor draw from the age-appropriate topic list to initiate conversation make eye contact exhibit active listening skills by reflecting back and positively conclude the interaction with 75 consistency in 45 targeted observational periods

Impulsivity Goal By __ when given 11 Support direct and small group instruction role playing opportunities a self-monitoring checklistdecision making tree Student will replace her impulsive decisions and negative peer influenced decisions with using a decision making tree to make her own decisions independently in 45 observational periods

B1 By __ when given direct and small group instruction Student will demonstrate 1) how to make a decision using a decision tree 2) practice using a decision tree to make decisions in role-playing situations 3) process with behavior specialist the potential positive and negative outcomesconsequences of previous decisions 4) create a positive decision journal that she will record the positive decisions she has made in the previous 24 hours in 45 targeted opportunities B2 By __ when given a verbal prompt to use her checklist or decision-making tree Student will use her decision-making tree when making a decision in structured and unstructured situations She will also document her positive decisions daily in 45 targeted periods B3 By __ Student will independently use her decision-making tree and self-monitoring checklist when making decisions and document her positive decisions weekly in 45 observational periods

Transition Behavior Goal By _____ when given direct instruction in school survival skills and what to expect on a mainstream campus(homework expectations social expectations and anger management plan) Student will verbalize the expectations of a mainstream campus verbalize problem solving strategies to use and show mainstream behavioracross all academic settings with 80 consistency

B1 By ____ Student will participate in direct instruction in 1) list the homework expectations of a mainstream campus 2) define what mainstream behavior looks like and list the social expectations of a mainstream campus 3) list problems that may arise for him on a mainstream campus 4)create a list of potential problems and problem solving strategies including using a designated point person on the mainstream campus 5)accurately rating his school behavior (using his PBT)


B2 By _____ Student will exhibit mainstream behavior at school and rate his behavior daily (using his PBT) with 70 consistency and accuracy B3 By ______ Student will exhibit mainstream behavior at school and rate his behavior daily (using his PBT) with 80 consistency and accuracy

Me Book Goal By_____ given direct instruction and 11 support Student will compile a notebook containing her positive accomplishments positive activities she enjoys with others a list of her positive support people and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate Student will used this notebook to replace negative comments about herself with the ability to engage in positive discussions about her and othersrsquo strengths in 4 out of 5 targeted observations

B1 By_____ given direct instruction in creating a positive ldquomerdquo book Student will develop a positive accomplishments positive activities she enjoys with others a list of her positive support people and daily positive personal messages She will also identify positive peer or adult attributes that she would like to emulate She will complete a daily entry in 9 out of 10 targeted observations B2 By_____ given verbal prompts to use her positive ldquomerdquo book containing her positive attributes Student will complete the above activities daily (usually as a check out activity) in 9 out of 10 opportunities B3 By_____ Student will initiate asking for and independently complete the above activities in her positive ldquomerdquo book She will also engage in positive discussions about her strengths and the strengths of others when appropriate throughout the day in 4 out of 5 targeted observations

Off Task Academics Goal By ____ given direct instruction and a visual cueing system Student will replace distracting behaviors ie talking in class drifting off tapping and doodling with staying focused and on topic during academics in 45 observational periods

B1 By _____ given direct instruction in identifying and monitoring his own distracting behaviors Student will record instances when he was engaging in distracting behaviors identify when he was engaging in them to establish a pattern and then identify replacement behaviors he could have used in 45 targeted observational periods B2 By ____ when given only verbal promptsredirection or nonverbal prompts (eye contact visual cueing system) and a self-monitoring desk chart Student will self-monitor his distracting behaviors in 45 targeted observational periods B3 By _____ Student will independently self-monitor and correct his distractible behaviors in 45 targeted observational periods

Passivity Goal By ____ given direct or group instruction verbal scripts a daily self-evaluation sheet and check-in with staff Student will replace making excuses blaming others lying and passive learner behaviors (head on desk off topic comments non-responsive behavior when given feedbackredirection non-participation) with taking responsibility for his choices and education as manifested by telling the truth following staffrsquos directions self-correcting behaviors when given feedbackredirection andor using taught positive verbal scripts and accurately reflecting on his behaviors by filling out a self-evaluation score sheet on a daily basis in 45 targeted observational periods

B1 By ____ given individual or group instruction in the value of owning both his positive and negative choices and how taking responsibility for his behaviors and education will allow him to play an active role inhis life Student will create and practice a ldquostop and thinkrdquo routine and develop and practice positive verbal scripts that he can use to accept feedback directions and non-preferred activities Student will also practice proactive classroom participation skills (such as keeping his head up staying on taskon topic raising a quiet hand and waiting to be called on and asking for help) Finally at the end of each school day Student will fill out a self-evaluation score sheet for these target behaviors and engage in a brief discussion of his ratings with staff in 34 instructional sessions


B2 By ____ given individual or group instruction in the value of owning both his positive and negative choices and how taking responsibility for his behaviors and education will allow him to play an active role in his life Student will create and practice a ldquostop and thinkrdquo routine and develop and practice positive verbal scripts that he can use to accept feedback directions and non-preferred activities Student will also practice proactive classroom participation skills (such as keeping his head up staying on taskon topic raising a quiet hand and waiting to be called on and asking for help) Finally at the end of each school day Student will fill out a self-evaluation score sheet for these target behaviors and engage in a brief discussion of his ratings with staff in 34 instructional sessions B3 By ____ given taught verbal scripts a ldquostop and thinkrdquo routine and 1 prompt from staff Student will take responsibility for his choices and his education by following staffrsquos directions first time asked accepting feedbackredirection without verbal retort andor using a positive verbal script to accurately reflect on his behaviors through accurate scores on his self-evaluation score sheet in 45 targeted observational periods

Perception of Social Interactions Goal By ___ when given direct instruction in the verbal and nonverbal pattern of social interactions identifying and labeling the perspectives of others verbal and nonverbal prompts and a self-evaluation protocol Student will replace her inability to accurately evaluate her social interactions and how others perceive her behavior with the ability to independently and accurately evaluate her social interactions in 45-targeted observational periods

B1 By ___ when given direct instruction in the verbal and nonverbal pattern of social interactions Student will identify components of positive social interaction and complete her self-evaluation protocol when role-playing staff directed scenarios in 33 targeted observational periods B2 By ___ when given verbal and nonverbal prompting and additional staff coaching Student will complete her self-evaluation protocol and will compare her perceptions with that of staff in 35-targeted observational periods B3 By ___ when given verbal and nonverbal prompting and additional staff coaching Student will complete her self-evaluation protocol and will compare her perceptions with that of staff in 45-targeted observational periods


Student Needs for Mental Health Support Rubric

Student Name DOB_____ _ Disability ____ _ Date Reviewed ____ _ _

Case Manager School _____ _ District _____ _

0

1

2

Accesstolnstruction

Regular attendance No suspensions or other disciplinary actions that result in removal from class Remains in class for the entire school day

Occasional need to remo ve student from classroom due to presenting prob lem (eg time away) Occasiona l somatic compla ints resulting in absences or time spent out of class ( eg w ith counselor or psychologist)

Regular ly out of class to seek support from counse lor psychologist or for disciplina ry issues Some absences likely due to somatic comp laints or avoidance

Education Progress

Completes assignments Grades and test scores reflect good progress in curriculum Progressing towards or meeting IEP goals

Noted academic progress Completes most assignments Grades test scores indicate some progress in curriculum and towards IEP goals

Inconsistent work completion Some refusal to complete non-preferred tasks Data suggests limited academic progress

Severity of Symptoms

Does not manifest symptoms in the school setting

Occasional manifestation of symptoms in the school setting (eg mood dysregulation anxiety somatic comp lain ts irritability or anger)

Frequent (several times a week) manifestation of symp tom s in the schoo l setting Exhibiting obvio us signs of anxiety or depression

Response to Current Intervention

Does not require school based intervention

Has made noted progress with school based interventions Participates willing ly and regularl y

Participation in school based intervention is inconsistent Little or inconsis tent progress towards resolution of presenting problem

Rule out s to consider

There is nothing to rule out

Look at primary eligibility to make sure it is accurately encapsu lation the behaviors manifesting in the academic env ironment

Students primary eligibility is Autism OHi other behaviorally related issue Behaviors disp layed are directed correlated to this condition

3 Frequent time spent out of class due to emotionalbehavioral outbu rsts Possible suspensions Repeated disciplinary actions Some instances of school refusal

Minimal academic progress Completes few assignments Frequent refusal to engage in non-preferred academic tasks

Chronic symptoms-manifested on a daily basis May require shortene d day Possible attempts to leave cam pu s (running) Expresses thoughts of self harm or suicidal ideation

School based intervention results in no changes in presenting problem

Student has co-morbid condition but the team is unsure if mental health or behavioral symptomatology is impacting the student the most from accessing his or her curriculum

4 Minima l access to instruction Suspended forgt 10 days per school year Excessive absences School refusal Consistently out of class due to emotional or behavioral issues

No academic progress Failing grades No work comp let ion No progress towards goals

Manifesting severe symptoms that cannot be managed at school Requiring hospitalization or home teac hing

Student unwilling or unavailable school based intervention

for Student has co-morbid condition and it is clearly documented that the mental health symptomatology is impacting the student from accessing his or her curriculum on a daily bas is

Attach a copy of documentation indicating frequency and duration over a period of time to determine further consideration of Mental Health support If mostly ratings of 3s amp 4s in two or more areas please continue with needs assessment process


Sample Documents Family Educational Rights and Privacy Act (FERPA)

Sample Monthly Service Summary Report Educationally Related Mental Health Checklist

Progress Notes for Individual Group Consultation and Parent Education (Available upon Request Templates located on Healthmaster)

Consent for Treatment (Available upon Request) Risk Assessment Sample (Available upon Request)

BHRS Referral Information

Family Educational Rights and Privacy Act (FERPA)

The Family Educational Rights and Privacy Act (FERPA) (20 USC sect 1232g 34 CFR Part 99) is a Federal law that protects the privacy of student education records The law applies to all schools that receive funds under an applicable program of the US Department of Education

FERPA gives parents certain rights with respect to their childrens education records These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level Students to whom the rights have transferred are eligible students

Parents or eligible students have the right to inspect and review the students education records maintained by the school Schools are not required to provide copies of records unless for reasons such as great distance it is impossible for parents or eligible students to review the records Schools may charge a fee for copies

Parents or eligible students have the right to request that a school correct records which they believe to be inaccurate or misleading If the school decides not to amend the record the parent or eligible student then has the right to a formal hearing After the hearing if the school still decides not to amend the record the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information


Generally schools must have written permission from the parent or eligible student in order to release any information from a students education record However FERPA allows schools to disclose those records without consent to the following parties or under the following conditions(34 CFR sect 9931)

School officials with legitimate educational interest Other schools to which a student is transferring Specified officials for audit or evaluation purposes Appropriate parties in connection with financial aid to a student Organizations conducting certain studies for or on behalf of the school Accrediting organizations To comply with a judicial order or lawfully issued subpoena Appropriate officials in cases of health and safety emergencies and State and local authorities within a juvenile justice system pursuant to specific State law

Schools may disclose without consent directory information such as a students name address telephone number date and place of birth honors and awards and dates of attendance However schools must tell parents and eligible students about directory information and allow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them Schools must notify parents and eligible students annually of their rights under FERPA The actualmeans of notification (special letter inclusion in a PTA bulletin student handbook or newspaper article) is left to the discretion of each school

Legitimate interest is defined as the following per county counsel



For more information regarding this please visit wwwfamilypolicyedgov


Mental Health Provider Service Summary

Summary of Services Month of

510 Individual Therapy X students

515 Group Therapy or Push In Therapy X students

Mental Health Assessments X students

Teacher consultation X teachers

520 Parent Coachingconsultation X parents

Pending Students X students

Clinician School Assignments Names and schools

School 1 School 4 Total students Total students

Total Weekly Minutes Direct Total Weekly Minutes Direct

Total Weekly Hours Consult Total Weekly Hours Consult

School 2 School 5 Total students Total students Total Weekly Minutes Direct Total Weekly Minutes Direct Total Weekly Hours Consult Total Weekly Hours Consult


Procedures for BHRS Mental Health Referrals

1 At the IEP meeting discuss a referral for mental health assessment

2 Put mental health packet together (can be done prior to the IEP)


3 Have SEIS assessment plan signed by parent

4 Send signed assessment plan to district office immediately

5 District office will sign the packet and send out within 24 hours (working days) to BHRS

6 Mental healthBHRS will send a letter to the district office containing the following information When referral packet including assessment plan was received by BHRS Who has been assigned to complete the mental health assessment When the assessment is due

7 District office will send a copy of the letter to the site school psychologist

8 Site school psychologist will contact the parents to explain the letter and phone call that they will be receiving from County Mental Health Prepare the parent to promptly return calls from the assessor andgive parent the name

9 Mental health assessor will contact school psychologist to inform of window period that they are availablefor the MH eligibility and recommendation IEP School psychologist will connect the assessor with the case manager so they are included in the scheduling of the IEP

If parent has not made the student available for mental health assessment in a timely manner and the assessment may not be ready by the due date BHRS will contact the district office and the district office will contact the the site school psychologist BHRS will provide documentation of delays via emails to director to be placed in a student file to provide records for CDE reporting) The school will open an IEP meeting explain the parent did not make the student available for the mental health assessment then close the meeting The mental health assessor will be available by phone for this meeting The school will then fax the signature page to the mental health assessor for signature who will then immediately fax the signed copy back to the school The IEP will be reconvened as soon as possible when the mental health assessment is completed so that services are not delayed

San Mateo County Behavioral Health amp Recovery Services (BHRS) School-Based Mental Health (SBMH) Required Elements

Referral for Service andor Assessment

Please provide one copy of all information single-sided only

I Referral Information Form - 3 pages Complete identification information Primary district contact for student clearly identified - include phone number Complete explanation of referral issues Pre-referral interventions documentation if any (Recommended minimum of 3 months)

II SELPA Assessment Plan signed by parent Indicate Mental Health Assessment in Other box


Indicate Mental Health Provider in Examiner Title column

III SELPA Exchange of Information Form signed by parent Informed Consent has been provided in home language Signature represents person with legal authority to give consent BHRS andor other providers noted in permission to exchange information section

IV Psychoeducational evaluation or other District assessments Psychoeducation evaluation is current and complete Mental health issues have been assessed and are documented Concerns are clearly a mental health issue not aspect of disability Cognitive ability is sufficient to benefit from psychotherapy

V IEP documents IEP with team agreement for SMBH services signed by parentguardian Most recent Annual IEP included All IEPrsquos since last Annual and other relevant IEPrsquos included

Behavior andor emotional issues impede learning Level of Special Education intervention sufficiently intensive Social and emotional goals have been implemented Behavior support plan has been implemented if indicated Outcome of LEA interventions documented in IEP

Send referrals to San Mateo County BHRS 1290 Commodore Drive San Bruno CA 94066

Phone (650) 583-1260County Pony Mail or US Mail We do not accept referrals via fax or email


Structure Bookmarks



Ma teo Ocnmty

EPA

Special Education Local Plan Area (SELPA) 101 Twin Dolphin Drive bull Redwood City CA 94065-1064 bull (650) 802-5464 bull Fax (650) 802-5474

Educationally Related Mental Health Services Procedures

History Both education and mental health systems have a long history of providing mental health services to studentsSometimes these services are delivered collaboratively between the two systems but more often the services work in parallel fashion with each other or do not operate effectively at all in either system (Kutash Duchnowskiamp Lynn 2006) California utilized the legislative process to define the relationship between the public school system and county mental health In 1984 Assembly Bill 3632 statutorily required a partnership between school districts and county mental health agencies to deliver mental health services to students with individualizededucation programs (IEPs) In 2011 the California Legislature passed Assembly Bill 114 which repealed the state mandate on special education and county mental health agencies and eliminated related references to mental health services in California statute As a result of this new legislation school districts are solely responsible for ensuring that students with disabilities receive special education and related services to meet their needsaccording to the Individuals with Disabilities Education Act (IDEA) of 2004

Mental health as a related service is identified as mental health services necessary for a student to benefit fromtheir special education program Within the educational environment these can include assessment of needs for mental health services crisis intervention within the educational setting outpatient counseling day treatmentplacement case management parent consultation andor residential placement recommendations Please note that medication management is not included among these services since federal guidelines consider it a medically necessary and not an educationally necessary service The term ldquomental health as a related servicerdquo is currentlyutilized in place of ldquoAB3632rdquo or ldquo265 servicesrdquo Mental health a related service and Educationally Related Mental Health Services (ERMHS) can be used interchangeably

Such significant reform requires intensive action sustained over several years It involves not only putting intoplace the latest policy but also changing the cultures of classrooms schools and districts (Fullan 1991) Parents schools and communities all have a role to play in making sure children develop in a healthy way Creating nurturing environments for children promotes healthy development The Preventing Mental Emotional andBehavioral Disorders among Young People brochure (National Academies Press 2009) indicates

Healthy children feel good about themselves and their abilities They make friends get along with their peers and can cope with lifersquos stresses Healthy children learn and behave appropriately at school

Healthy families are nurturing and positive provide stimulating activities engage in positive communication and provide support for their children especially during times of stress

Healthy schools expect children to do well academically have teachers who manage their classrooms well and offer opportunities for partnerships with parents



































































IEP Procedures

























































HIPAAFERPA








































Curriculum



Team

Tier 3 BHRSNPANPS







Not a1iprovcd



l 1





I

f







_I





Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






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Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks




































































IEP Procedures

























































HIPAAFERPA








































Curriculum



Team

Tier 3 BHRSNPANPS







Not a1iprovcd



l 1





I

f







_I





Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks






















































HIPAAFERPA








































Curriculum



Team

Tier 3 BHRSNPANPS







Not a1iprovcd



l 1





I

f







_I





Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks







































Curriculum



Team

Tier 3 BHRSNPANPS







Not a1iprovcd



l 1





I

f







_I





Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks




Not a1iprovcd



l 1





I

f







_I





Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks






Placements


Vendors

1 Beacon

2 BHRS


4 StarVista














School Type Codes

CODE Description





76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks



76






















Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks








Services











Treatment Services

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks

















2 Nonpublic School




























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks



























































Service Options







Examples







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks







Harmful Effects








school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks






school of residence













State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks







State Funds




Federal Funds








































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks







































Supervision









Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks




Supervision



























Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks





















Common Uses

I

Goals







nterpersonal skills




-- - - - - -- - --












rogramming






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks






5671))











Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks




Title Example



BHRS































0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks


























0

1

2

Accesstolnstruction




Education Progress























































































Structure Bookmarks






























































Structure Bookmarks

